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Mental Health Books:
Voluntary Madness: My Year Lost and Found in the Loony Bin

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Manufacturer: Viking Adult

List Price: $25.95
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The journalist who famously lived as a man commits herself— literally

Norah Vincent’s New York Times bestselling book, Self-Made Man, ended on a harrowing note. Suffering from severe depression after her eighteen months living disguised as a man, Vincent felt she was a danger to herself. On the advice of her psychologist she committed herself to a mental institution. Out of this raw and overwhelming experience came the idea for her next book. She decided to get healthy and to study the effect of treatment on the depressed and insane “in the bin,” as she calls it.

Vincent’s journey takes her from a big city hospital to a facility in the Midwest and finally to an upscale retreat down south, as she analyzes the impact of institutionalization on the unwell, the tyranny of drugs-as-treatment, and the dysfunctional dynamic between caregivers and patients. Vincent applies brilliant insight as she exposes her personal struggle with depression and explores the range of people, caregivers, and methodologies that guide these strange, often scary, and bizarre environments. Eye opening, emotionally wrenching, and at times very funny, Voluntary Madness is a riveting work that exposes the state of mental healthcare in America from the inside out.


PRODUCT DESCRIPTIONS:

Binding: Hardcover
Dewey Decimal Number: 362.21092
EAN: 9780670019717
ISBN: 0670019712
Label: Viking Adult
Manufacturer: Viking Adult
Number Of Items: 1
Number Of Pages: 304
Publication Date: 2008-12-30
Publisher: Viking Adult
Studio: Viking Adult


SIMILAR ITEMS:

• Self-Made Man: One Woman's Year Disguised as a Man
• The Hour I First Believed: A Novel
• Wishful Drinking
• Outliers: The Story of Success
• Mrs. Astor Regrets: The Hidden Betrayals of a Family Beyond Reproach


CUSTOMER REVIEWS:

One Star for Chutzpah -
As others have noted, the author's tale of her voluntary admissions is only modestly interesting. What really put me off, though, was the growing realization that she feigned serious mental illness order get another book deal. And since this is a memoir, that's an integral part of the story and can't be dismissed. A fair comparison, I think, would be faking cancer to show really goes on in the ward. On top of that, all of the institutions are unnamed and patients she interacts with are anonymous. So I give the book one star for chutzpah.

Inane and Boring -
Vincent's mental difficulties began in her late 20s while working as an over-qualified secretary and wondering what the value was of her expensive prior education. He psychiatrist began Norah on Prozac, then tried others, and eventually she ended up on a maintenance dose of Prozac.

Then, after 18 months disguised as a man (subject of her first book), Vincent had become severely depressed, and her psychiatrist convinced her to enter a locked mental ward. A four-day stay motivated her to do a year within a mental hospital (actually three facilities, spread across the socio-economic spectrum) as the subject for another book.

After too many pages of day-to-day reporting on life in a deliberately sterile mental environment in which her main focus was getting off Prozac, she concluded that mental institutions have little impact - a person has to change themselves, most don't even try. The result is the apathetic staff that she found prevalent.

Vincent's conclusions may be correct, but her methodology is useless. Controlled studies involving a large number of patients with a specific mental problem are required, and that in turn requires clearer definitions and symptoms of mental illness, as well as rigid evaluation of patients at specified time-frames. The analysis must be repeated with each diagnosis that the conclusions are meant to apply to.

An even more glaring failure of "Voluntary Madness" is her arbitrary dismissal of psychotropic drugs. "Ignorant" and "irresponsible" are two terms that describe this conclusion.

Bottom Line: "Voluntary Madness" uses inane methodology to draw potentially seriously harmful conclusions for the mentally ill. It's boring as well.

Bound to be controversial, but much-needed commentary -
Vincent, who is actually a genuine former involuntary patient in a mental institution, decides to return to three different institutions to study, experience, and analyze how the systems work (or don't work), and what happens to the people inside-- both patients and employees.

This fact that she was a former patient gives her book an edge upon which she has had to tread lightly: If she hadn't formerly been committed, it would be easy to suggest that she didn't truly understand, because she had gone there by choice as someone who wasn't really sick. Yet, the fact that she has been formerly committed will likely give many people pause, as they consider her analysis and conclusions, and wonder if her judgment can be trusted as a coming from a reliable narrator.

This dilemma, although not specifically addressed in the book, is really at the heart of what Vincent seems to be suggesting overall about mental health, however. Most of the time throughout the book (there are exceptions) Vincent is fairly even-handed in her analysis of her experiences. She is almost always quick to offer oppositional arguments for why many of her questions are unwarranted. Yet it is the fact that there are so many unanswered questions that makes Vincent's book an indictment against the mental health industry. Anyone employed in the mental health field or training for such, or anyone who accepts the identity of their psychological diagnosis will probably hate this book.

For the rest of us, what her book does is raise the issue of how little we actually know about mental illness, while pretending, labeling, and treating people as if all causes and outcomes are well-documented. Some of the great questions to come out of this book include, why are psychological professionals unable to reliably diagnose mental illness? (That is, why are diagnoses inconsistently applied based on who is doing the diagnosing?) Why is 'taking the patient's word for it" good enough for a diagnosis, but then if the patient states that s/he no longer feels ill, their words cannot be trusted? Why are medications that are so poorly understood administered to patients so carelessly and frequently?

Although I would certainly hesitate to suggest that any policy decisions should be made based on her anecdotal experiences and conclusions, it is difficult to argue that many of the questions she raises deserve serious, evidence-based answers from the psychological community, which-- and she is right about this-- has not yet been forthcoming with them. This is probably not due to any sinister reason, but more because at this point, we simply as a people do not yet fully understand how our brains work.

Although some people will not like it that the mental health industry is being criticized, the reason why we need more work like this is because it would be foolish to pretend that only good comes out of the industry. Although certainly some people are helped by some procedures and medications, some people are also harmed and the more we know, the more we can reduce the latter.

Dismayed -
I was really dismayed by Vincent's depiction of phsychiatric drugs in Voluntary Madness, particularly antipsychotic drugs like Seroquel.

As someone whose mental illness (schizoaffective disorder) is and was NOT voluntary, I could tell Vincent that, for me, Seroquel made and continues to make the difference between life and a living death.

The onset of my illness brought loud and threatening hallucinations (voices that threatened to kill me and worse). I was treated with a variety of drugs, the first of which were not very helpful for me.

When my doctor tried giving me Seroquel, however, my life returned to normal as the drug built up in my system. The delusions stopped almost completely, and what voices I heard from then on were and are few and far between. They were also easy to distinguish from real sounds and ceased to be frightening--they became merely annoying and easy to ignore.

While the drug was sedating at first, my body adjusted to it very quickly (it is usually taken at bedtime for this reason). I could also tell Vincent that I certainly DO NOT twitch, drool, or fall asleep during daily activities!

If and when people experience these side effects from drugs, their doctors should withdraw them slowly and gradually while starting them (also slowly and gradually) on new ones. Unless I missed it, Vincent failed to mention that this simple solution to these problems is even possible.

Stopping any psychiatric drug slowly and gradually, under a doctor's supervision, is also an easy way to avoid a painful withdrawal. Vincent demonizes Effexor, for example, as causing withdrawal, but she never mentions that this withdrawal is avoidable.

She also observed that antidepressants and anipsychotics did not seem to work on the real patients on her ward. Well, unlike aspirin, these drugs usually take weeks and even months to build up to a theraputic level in the body. This is something Vincent would have known had she done a bit of research.

Vincent seems intent on making a career of posing as things that she is not. Still, she should have educated herself MUCH better on the subject of severe mental illness and the drugs used to treat it before filling Voluntary Madness with her baseless opinions.

Instead of writing a book about mental illness and its treatments (especially psychopharmacology), Vincent should have read one!

I would like to recommend three books to her or anyone else who wants to read a good first-hand account of mental illness and its treatment:

The Center Cannot Hold by Elyn R. Saks

The Quiet Room by Lori Schiller

An Unquiet Mind by Kay Redfield Jamison

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