benightedly i gave this 4 stars i'm sorry/you are/yes/why did you give it 4 stars/i wanted it to be like Aof R/ poetry is never the same/as i'm learninbenightedly i gave this 4 stars i'm sorry/you are/yes/why did you give it 4 stars/i wanted it to be like Aof R/ poetry is never the same/as i'm learning mostly from the reviews i am too inexperienced to learn from the book itself/some of these poems are surreal/they are/you don't like surreal/i like surreal but it doesn't quite talk to me the language seems gimmicky to me without/ i've heard this before/wisdom i guess/poetry's curse/insight quotability a light/we fumble in the dark/there's a glacier then there is a volcano polar opposites/which pole/i'd say the north pole/it's the easiest to assume/there is no life at the south pole except of course that which the explorers bring basically themselves/you mean native life but then how would we know/i mean currently/ah, temporality/i loved io/she's feathery and magic/thank you/you're welcome/i hate war/me too...more
this is so good. so so so good. i'm going to say, first of all, that the quality of the artwork is amazing. great drawing, sometimes really simple, sothis is so good. so so so good. i'm going to say, first of all, that the quality of the artwork is amazing. great drawing, sometimes really simple, sometimes really complex, with great utilization of über cool graphic devices (notably, a spiral notebook that seems like the real thing, ellen's real notebook, photographed, and may or may not be).
when i first got the book i quickly scanned it and saw that it dealt with bipolar disorder solely in medical terms, i.e. as something the only effective treatment of which would be the right medication cocktail. now, i don't like that. at all. i really believe that mood disorders are a very complex mixture of genes and environment -- i believe that in everything human you can never take the environment out of the equation -- so i was sorry to see that the book kind of sold medication as the only approach to ellen's terrible pain.
the book sat on my shelf for a while and then it sat in a friend's house for another while and now i read it, and it's really not like that. i mean, it is like that, but, also, it isn't. yes, ellen only sees a psychiatrist and the psychiatrist's only overt contribution to her well-being is finding the right meds (which she eventually does). but the book is also very complex about the relation between ellen and karen, the psychiatrist, in that they have regular sessions for 13 years (and counting, i suppose), and in these sessions ellen really finds an anchor, a warmth, a haven of acceptance, love, and help.
also, the whole role of medication is problematized, analyzed, discussed, investigated, studied. this is cool.
ellen definitely comes out in this extraordinary memoir as well-rounded, interesting, and intriguing. this is the perfect companion to Alison Bechdel's Are You My Mother?: bechdel approaches her pain through psychoanalysis, fornay through medication, but there is the same level of complexity, engagement with one's life, and intelligence. seriously, this is brilliant and captivating and it was hard to put it down.
it seems to me increasingly important, as i think about these issues, to understand that there are things that work for someone and things that work for someone else. there's a strong strain in the "survivor" community that is virulently anti-drugs. i think it hinges on some people's disastrous experience with drugs. drugs can have terrible consequences on some bodies, and positive consequences on some other bodies. when you are someone whose life has been ruined by psych drugs, you tend to totalize your experience and proclaim them the devil. but they are not the devil for everyone. there are people whose life has been saved by psych drugs.
the other thing is that ellen's experience of psychiatry is incredibly gentle. her psychiatrist seems absolutely fabulous. this is not a common experience. many psychiatrists (all too many) are dismissive, arrogant, and belittling of their patients. this happens all the time. so if you work on getting better with a psychiatrist who actually listens to what you say, takes in what you want, and honors your experience with respect to what does and does not work for you, medication might be a much better experience than if you deal with a psychiatrist who simple decides what you should take/do/feel/etc.
i had a student once whose psychiatrist regularly mocked her. whenever she had something to say for herself, he'd say that she was being manic and to calm down. this was a kid. a college kid. i told her, why don't you change psychiatrist? but when someone gets into your head and makes you feel that he is god and you are an ant, you keep going back.
anyway, great book. thank you ellen for writing it. i don't know how you guys (you, alison, etc.) do it. this stuff must be harder than hell to put down on paper. so, again, thank you. ...more
this is a crazy, rollicking, fantastic, wild ride of a book into the life of young ursie koderer, a totally sane, if a little zany " * Unbeknownst Tothis is a crazy, rollicking, fantastic, wild ride of a book into the life of young ursie koderer, a totally sane, if a little zany " * Unbeknownst To Everyone" (where * stands for, in Ursie's own words, "lesbo") who, upon discovering that she is indeed attracted to girls rather than boys, goes a little crazy and is therefore carted off from summer camp directly into the loony-bin.
except, truly, she doesn't go crazy at all. the reasons why ursie ends up in the bughouse are, as is often the case, completely serendipitous and due to a mixture whose main ingredients are: a) she draws maps and other hieroglyphics on her arms with razor blades; b) she likes girls, which c) leads her to commit various acts of minor meshugas; d) her mother is dead and her father is a famous someone who doesn't have time to devote to her daughter while having instead e) lots of dough to spend on a fancy psych hospital so that said daughter can be kept out of the way and out of trouble for two years.
in spite of its fabulistic and surreal texture this novel reads for all the world like autobiography -- also, truly, who writes a story about teenagers in the loony-bin except someone who has been there? -- and, in fact, in this startlingly honest interview jaimy gordon discloses that this is the story of her own sister (hmm, sister?), swaddled in inventive language and over-the-top picaresque-ness for disguising purposes and also because that's how jaimy gordon writes.
now this style of narrative isn't my favorite -- in fact, it's rather distant from my taste, as i really truly like my fiction to be as narrowly realistic as possible. also, i confess to having had my fill of stories about kids capering in the asylum. hence the entirely subjective docked star. this book deserves five stars for its language alone, which is truly unique and, if you like this kind of stuff, really funny.
the beauty of the story is that ursie comes into her own thanks to the unorthodox ministrations of a visiting psychiatrist from a central-asian soviet republic. this is easily the best part and i won't spoil it for you. let me just say that, under the guise of fun and story, this book contains a cutting critique of traditional freudianism and traditional psychiatry. while sending up their strictures and prohibitions, it celebrates freedom, lust, life, passion, love, sex and the miraculously healing relationships patients and therapists create with each other in spite of structures often designed to keep them apart. ...more
this is a grim but i think mandatory history of psychiatry in america. it seems to me that, at this time, the people we can truly trust when it comesthis is a grim but i think mandatory history of psychiatry in america. it seems to me that, at this time, the people we can truly trust when it comes to exploring mental health culture are investigative journalists. this book is not kind to psychiatry, and i think this is exactly as it should be. whitaker documents painstakingly every assertion he makes and shows us a discipline that was born wrongly and retains to this day the misguidedness of its roots. i don't know about other countries (there are shameful things described in this book that are solely and proudly american), but here in the US psychiatry has no chance to start doing good instead of harm if it doesn't scratch itself out and go back to square one.
whitaker describes the origins of american psychiatry as a debate between viewing the mentally ill (mostly people with psychotic symptoms, but also those suffering from melancholy and the plain wayward as assessed by doctors and families -- hence the disproportionate attack on women, whose societal roles were/are particularly burdensome and social influence correspondingly weak) as animals or as people. the mentally-ill-as-animal school of thought won and everything went downhill from there.
the eugenics movement gave a scientific veneer to this way of thinking by placing the mentally ill squarely into the domain of the sub-humanly defective, which gave license to psychiatrists of the time (second half of the 20th century) to do with them pretty much as they wished.
the advent of neuroleptics/antipsychotics (many of which are currently marketed as safe alternatives to run-of-the-mill antidepressants and quite liberally dispensed -- see Abilify) allowed doctors to "treat" the "mentally ill" (see definition above) in ways that look much less brutal but feel incredibly painful to those who have to endure them (ever wonder why keeping people on their drugs is such a problem?).
beside being mostly ineffective and painful (especially at large dosages and as maintenance drugs), antipsychotics can have a devastating effect on the brain, but you won't find many psychiatrists warning you of this, even though i believe state laws compel them to (not sure about this). to the contrary: medication can now be forced on patients via court injunction, and some insurance companies won't pay for therapy unless patients take their drugs. the same is true for electroshock (bet you thought we didn't do this any more), as a current case in minnesota outrageously confirms (the mindfreedom page could be better organized. make sure to click the various links for background pieces).
the main philosophical underpinning of all that is wrong with psychiatry (and a lot of modern medicine) is that, quite literally, patients have no voice. no one listens to the mentally ill. there is absolutely no recourse for psychiatric abuse in the justice system (which, as we can see from the minnesota case, is quite gleefully allied with doctors) and often even families will side with doctors. we all breathe the same cultural air.
if you show up in the emergency room in a state of acute distress, chances are no one will sit down and really talk to you. if they do talk to you, they’ll talk to you for 10 minutes and their only goal will be to assess whether to hospitalize you or not. once they decide you need to be hospitalized, you will have no appeal.
i am not blaming individual psychiatrists for this – especially, god knows, overworked and swamped ER psychiatrists. i am blaming a culture that has considered the “mentally ill” incapable of sound judgment and agency from the moment of its birth. i also blame the systematic weddedness of psychiatry to pseudo-science. whatever anyone tells you, our scientific understanding of why minds go awry and what makes them better is in its infancy. we know next to nothing. we are testing hypotheses. and we are testing them on the bodies of the mentally ill.
which brings me to current problem number one, the lovely friendship between psychiatry and pharmaceutical companies. it seems a no brainer to anyone who is capable of forming a simple thought that pharma money and the medical profession should be separated by an impenetrable barrier. what happens, instead, is that pharma money pretty much sustains and feeds our doctors. as consumers we must be savvy to this. doctors whose waiting rooms are plastered with pharmaceutical ads should be simply dumped. it can be hard because some of them are really nice, but there is no other way. similarly, health or mental health publications that carry pharmacological advertising (Psychology Today is one of those) belong in the trash can.
i read this book in class and it left my students frankly shell-shocked. even though it was published in 2002 and documents deceitful medical trials for psychiatric drugs occurring as late as 1997, my students hung on tooth and nail to the idea that “fortunately we don’t do this any more.” Unfortunately we do this more than ever. ...more
*** the review below was written some time ago. now that i have read the whole book i don't have a whole lot to add except the following. this book de*** the review below was written some time ago. now that i have read the whole book i don't have a whole lot to add except the following. this book deserves to be read widely and carefully. it's a wonderful book and a delightful, riveting read. it's written as a story and it's packed with beauty, intelligence, wisdom. it is a clarion call for much-needed change. if we continue treating mental illness the way we are currently doing (especially in the US), we will create a larger and larger generation of unnecessarily diminished, crippled people. we need to rethink the way we approach madness. we need to get the pharmaceutical and the insurance companies WAY under control. we need to radically restructure the system of care. we need single payer, universal, government-sponsored health care. we need to find a way to address the systemic and systematic sadism of mental health care providers. we need to get the consumers into the conversation and grant them full agency, control, and personhood. we need to eliminate compulsive care. we need a movement the size of the women's movement, the gay rights movement, and the disability rights movement. nothing will change without a movement. ***
i read up to page 90. i read fast and furiously, and was very bummed when i couldn't carry on because the descriptions of psychosis were bothering me. this book is GREAT and i have no doubt i'll come back to it, finish it, reread it, teach it, spread it, gift it, learn from it. i am tempted to say it's the best popular book about hallucinations and psychosis i've read, and i am aware that it's a book written by a psychologist and not a "voice hearer." but gail hornstein has been solidly on the side of the patient for many years (she was the first to compile a list of patients' autobiographies and memoirs of "mental illness" in english and her list is still invaluable). as for her account, she was eight-balled for her refusal to follow the status quo in its infantilization, other-making, and pathologizing of people in psychic pain, and had to do some of her pro-patient work stealthily. the book is so respectful, profound, and full of integrity, i could not find an ounce of condescension or superiority in it, not even of the anthropological kind. hornstein goes to Hearing Voices Network meetings in the UK for years, and then does the same in the US with Freedom Center meetings. she doesn't hide her identity, asks permission of the group members to be at the meetings, and behaves exactly as the other people -- partaking in the tragedies big and small of voice hearers, sharing her experience, and chipping in when help (generally of the listening kind, sometimes of a more concrete sort) is needed. in other words, she becomes one of the guys and one has the impression she doesn't miss a meeting. since she's not a clinician, she doesn't "treat" anyone -- not that anyone wants to be treated. she learns, shares, empathizes, lives with, learns some more.
hornstein's language is admirable in its consistent refusal to use the terminology of pathology, diagnosis, and difference. you learn from what she says, but you also feel yourself shifting paradigm (what a relief!) just reading how she says it. instead, she uses diversity, and, on occasion, giftedness as guiding ideas. she does not deny the presence of pain, but she seems to attribute a lot of it -- basing herself on what the voice hearers say about their experience -- to the way voice hearers are treated by mainstream psychiatry (mainstream here is almost redundant) and our disgracefully marginalizing, stigmatizing, and punishing culture of normalcy. she explains that, like the rest of us, voice hearers learn to act the way we expect them to, and once restored to normality (i.e. to acceptability and acceptance within a group of peers) they lose a lot of their self-abasement and strangeness.
one of the things that make this book so compelling is that hornstein writes beautifully. this book is a genuine treat to read. i cannot recommend it enough, to EVERYONE, and i'm sincerely looking forward to reading it all myself. ...more
i didn't read the whole thing but, well, saks is obviously exceptionally bright, and she writes in a really approachable way. she writes sort of philoi didn't read the whole thing but, well, saks is obviously exceptionally bright, and she writes in a really approachable way. she writes sort of philosophically, if you are familiar with the analytic tradition, going through various scenarios and possible objections, covering all the possibilities, and it gets a bit tiring. but it's okay, it's interesting. at the end, though, she does allow for some coercion, not very much but some, and i am not a fan of coercion, none at all, period. it must be said that in her scenarios the coercion happens in a sort of best possible world, i.e. a world in which psych hospitals are nice, good, humane places (which they aren't). in her TED talk she slams both psych hospitals and coercion, no, she slams violence, and i wonder whether that's an evolution (there're about 10 years between this book and her TED talk) or whether the "violence" she descries in the TED talk is not the coercion she accepts in this book.
all in all, though, i wish this were a passionate defense of the autonomy of people suffering from mental pain, and a description of what needs to occur for everyone to be safe and well cared for -- and it isn't. but then she's not a passionate writer. she's a methodical, analytical, dispassionate, almost detached writer, so, well, this is the kind of book she wrote. ...more
just re-read this for class. maybe i'll post a a review later. for now, though, i raised my four-star rating to five. the ways in which KRJ thinks abojust re-read this for class. maybe i'll post a a review later. for now, though, i raised my four-star rating to five. the ways in which KRJ thinks about mental illness are not always congenial with mine, but this is a brave, beautifully written, and still very powerful book, many such memoirs later.
i'm not going to research this, but i think this was one of the first candid memoirs of mental disorder coming from someone famous/mainstream in the US and published by a major publisher. it was especially noteworthy because the author was (is) a mental health professional, a teaching and practicing clinician who had written what was probably the most authoritative textbook on bipolar disorder at the time (maybe it still is). that this woman who had climbed so high in a world of men would come out and say candidly that she had the very disorder she was considered an expert at treating was fairly shocking. bipolar people were and are not supposed to be able to think critically about their disorder (or much of anything), much less to treat it in others. i am not going to research this but i think this book became a bestseller.
although not herself a psychiatrist (her degree is in psychology), KRJ is a professor of psychiatry and her narrative of madness hinges on the unquestioned premise that bipolar disorder is a biological illness (she doesn't like the word "bipolar disorder," which had already been introduced in the DSM at the time of the book's writing, and prefers to refer to the condition as manic-depressive illness). this means that she embraces what is now referred to as the medical model of (this, at least) mental illness, according to which (this) mental illness is due solely to genetic factors which are responsible for a certain kind of malfunctioning of the brain. humbly, and wisely, KRJ sticks closely to her own disorder, never generalizing about mental illness in general.
this biological narrative is the backbone of the book. it allows KRJ to exonerate herself and her history for the terrible lows she experienced and believe that if it weren't for her illness she would perfectly fine.
this is incredibly complicated. it hits the core of the concept of illness in general, and identity, and, also, the fraught field of disability studies. if i am blind, am i perfectly fine except for the fact of being blind? do disabilities attach to the body in ways that leave the self intact?
i am not even sure that KRJ would agree with my pushing her premises to this conclusion. she definitely does not feel intact. her illness as she describes it affects her life so profoundly, i am not sure she feels that she is entirely separate from it. yet, a certain separateness between the self and the illness is a consequence, it seems to me, of an extreme view of the medical model and of certain conceptions of disability.
needless to say, i don't find the medical model convincing. for one, there is to this day no hard evidence of any kind that mental illness is biologically based. there is some anecdotal evidence based on heredity, brain scans, and the sometime effectiveness of drugs, but just about all of the above can be explained in other ways, too. more damningly, there is the fact that mentally "ill" people have lively and rich inner lives that we can explain away through biology only by denying some of the most fundamental tenets of humanness. according to a strong medical model, distorted thoughts, hallucinations, obsessions, phobias and dreams are all the result of misfiring neurons and have no significance at all. as such, they don't lend themselves to more then the 15 mins conversation required to decide what drug treatment to adopt.
the reality is that drug treatment decisions are so arbitrary and themselves anecdotal, there is no single drug that is guaranteed to solve a particular mental disorder, the way, say, antibiotics are guaranteed (well, less and less) to cure infection or insulin to keep diabetics alive.
it seems at the very least perplexing to me that some thought patterns should be granted credibility and some shouldn't. if you rule out the meaningfulness of the bizarre thoughts of a schizophrenic, why should i lend credence, say, to the thought process that leads you to such ruling out? what makes your thoughts more valid than those of a schizophrenic?
so this was always my reservation with respect to this book. having just reread it, though, and seen its impact on my students, i have come to appreciate its complexity and value. first of all, it is remarkably and even outrageously candid. this woman's courage in risking her professional standing to tell an extremely uncomfortable truth about mental illness deserves great admiration. i believe that this book has done much to remove some of the stigma that attaches to mental illness.
secondly, it is written passionately and lyrically, and some passages (especially in the last part) are deeply moving. this is a woman who knows pain, despair, and abject suicidality, and if you know them too you will find in her a fellow traveler and a beacon of hope.
what i like best, though, lies at the meta-level. when pain hits us harder than we can bear it, we desperately need a narrative that makes sense of it and, in doing so, allows us to survive. in Unquiet Mind KRJ may or may not be telling something informative about bipolar disorder, but she is certainly giving us the narrative she created for herself in order to survive the intolerable pain she was experiencing and even thrive in spite of it. This seems to me of tremendous value. If even one person found in this book a story that helped her carry on and succeed in putting together a satisfactory life, the book would be worth its ink in gold.
when KRJ wrote Unquiet Mind the capacity of lithium to stabilize mood had just been ascertained. since then, lithium has been proven to be also very dangerous, so if you read this and your (uninformed) psychiatrist puts you on a gigantic lithium regimen, read up on the internet what lithium can do to your body. there are a number of people who have lost kidney function to the miraculous curative powers of lithium. on the other hand, maybe lithium works for you in small amounts, or other drugs do, and that's great. or maybe you are one of those people who prefer to live their bipolar lives medication-free, and if so more power to you (and the best of luck: you are going to to need a lot of resources to keep out of a very coercive pro-medication mental health system).
i have my own personal narrative of mental illness and it works for me. i think it's the right one and i am quite wedded to it. it is based on the so-called trauma model of mental pain and tends to be quite wary of the medical model. at the same time, i appreciate the well-being psychodrugs have brought to countless people, just as i appreciate the well-being people derive from: love, friendship, therapy, good food, yoga, exercise, comfort, compassion, and immoderate amount of chocolate.
there is no magic bullet when it comes to inner pain. we do well to keep this in mind at all times. ...more