Welcome to My Country: A Therapist's Memoir of Madness

by Lauren Slater

Lauren Slater, a brilliant writer who is a young therapist, takes us on a mesmerizing personal and professional journey in this remarkable memoir about her work with mental and emotional illness. The territory of the mind and of madness can seem a foreign, even frightening place—until you read Welcome to My Country.

Writing in a powerful and original voice, Lauren Slater closes the distance between "us" and "them," transporting us into the country of Lenny, Moxi, Oscar, and Marie. She lets us watch as she interacts with and strives to understand patients suffering from mental and emotional distress—the schizophrenic, the depressed, the suicidal. As the young psychologist responds to, reflects on, and re-creates her interactions with the inner realities of the dispossessed, she moves us to a deeper understanding of the complexities of the human mind and spirit. And then, in a stunning final chapter, the psychologist confronts herself, when she is asked to treat a young woman, bulimic and suicidal, who is on the same ward where Slater herself was once such a patient.

Like An Unquiet Mind, Listening to Prozac and Girl, Interrupted, Welcome to My Country is a beautifully written, captivating, and revealing book, an unusual personal and professional memoir that brings us closer to understanding ourselves, one another, and the human condition.

Genres: Psychology, Memoir, Nonfiction, Mental Health, Mental Illness, Biography, Biography Memoir

199 pages, Paperback

First published January 30, 1996

About the author

Lauren Slater (born March 21, 1963) is an American psychotherapist and writer.

She is the author of numerous books, including Welcome to My Country, Lying: A Metaphorical Memoir, Opening Skinner’s Box, and Blue Beyond Blue, a collection of short stories. Slater’s most recent book is The $60,000 Dog: My Life with Animals.

Slater has been the recipient of numerous awards, among them a 2004 National Endowments for the Arts Award, and multiple inclusions in Best American Volumes, and A Knight Science Journalism Fellowship at the Massachusetts Institute for Technology. Slater is also a frequent contributor to The New York Times Magazine, Harper's Magazine, and Elle, among others. She has been nominated several times for National Magazine Awards in both the Essay and the Profile category.

Slater was a practicing psychotherapist for 11 years before embarking on a full-time writing career. She served as the Clinical and then the Executive Director of AfterCare Services, and under her watch the company grew from a small inner city office to a vibrant outpatient clinic servicing some of Boston’s most socioeconomically stressed population.

After the birth of her daughter, Slater wrote her memoir Love Works Like This to chronicle the agonizing decisions she made relating to her psychiatric illness and her pregnancy. In a 2003 BBC Woman’s Hour radio interview, and a 2005 article in Child Magazine, Slater provides information on depression during pregnancy and the risks to the woman and her baby.

She lives and writes in Harvard, Massachusetts.

Reviews

[K · Rating 3 out of 5]

This is a tough book for me to review.

I tend to be drawn to collections like these where psychologists recount stories of their work with various patients. I enjoyed Love's Executioner and Other Tales of Psychotherapy and Momma and the Meaning of Life: Tales of Psychotherapy, and was anticipating something along those lines. Welcome to My Country was similar in some ways, but not the same.

In this book Lauren Slater remembers her work with both low-functioning group home patients with schizophrenia and higher-functioning but still troubled outpatients with depression and other issues. Slater's language is poetic, beautiful at times but also a bit distracting and vague. Reading this book was reminiscent of Houses of Study: A Jewish Woman among Books, another memoir which teased me with the promise of a story I'd surely be compelled by but ended up substituting poetic language and metaphors for the details which would make that story come to life for me.

I appreciated Slater's respect and reverence for her patients, her efforts to meet them where they were, and her willingness to acknowledge frustrations and failures. Unfortunately, though, most of these stories left me feeling like I wanted more. More concrete details about how the patients moved from point A to point B to point C, what their obstacles were, their back-and-forth, etc. More clarity on Slater's internal process and how it informed her work with the patients. Yes, there was some, but not enough for my taste.

Here, though, is why I almost upped the rating to four stars. In the final chapter, Slater writes poignantly about her own history -- the fact that she was once diagnosed with borderline personality disorder, hospitalized multiple times, suffered an eating disorder, engaged in self-mutilation, came from a chaotic family background, etc., etc., to the point where her hospital records reflect the prediction that she would be chronically admitted and readmitted to inpatient settings.

By the time we meet Slater she is clearly a successful psychologist, one who spent eleven years working with patients and expanding her clinic. The fact that a woman who had suffered so greatly went on to earn a Ph.D. and become someone who helped others who had suffered in similar ways is inspiring in and of itself. But what truly touched me was Slater's honesty about what might be called hypocrisy in the mental health field.

"I'm supposedly in a profession that values honesty and self-revelation," says Slater. "Training programs for psychologists like me...have as a credo the admission and discussion of countertransference [i.e., the therapist's emotional reactions to aspects of patients' presentation], which by necessity claims elements of private conflict." Yet, adds Slater, we therapists are given a double message. "Admit your pain, but only to a point. Admit it, but keep it clean. Go into therapy, but don't call yourself one of us if you're anything more than nicely neurotic." She writes about the "us vs. them" mentality which uses language to pathologize patients and separate them from their supposedly healthy and functional therapists.

At least one of the founding psychologists -- his identity escapes me -- emphasized the need for psychologists to be healthier and more functional than their patients. And of course that makes sense; you can't really help a troubled person if most of your emotional space is taken up with your own pressing uncontained issues. On the other hand, this concept was one which troubled me for a long time. I'm not a perfect person, or a perfect spouse, or a perfect mother. How can I present myself as any kind of guiding light to someone who struggles with issues that I struggle with myself?

Of course there are answers. My fallback one is that anything you've struggled with makes you a better therapist. And of course, we're not really supposed to have all the answers. But Slater's answer was a new, and powerfully articulated, one for me. "What sets me apart from these 'sick' ones," says Slater, "is simply a learned ability to manage the blades of deep pain with a little bit of dexterity. Mental health doesn't mean making the pains go away. I don't believe they ever go away. I do believe that nearly every person [including psychologists]...has the same warped impulses...as the wobbliest of borderlines, the most florid of psychotics. Only the muscles to hold things in check -- to channel and funnel -- are stronger. I have not healed so much as learned to sit still and wait while pain does its dancing work, trying not to panic or twist in ways that make the blades tear deeper, finally infecting the wounds."

Perhaps what Slater is saying is that mental health means a greater ability to compartmentalize. And that's why a therapist with their own pain can reach out to someone else in pain and teach them to contain that pain so that it no longer overtakes everything else they try to do. But Slater's honesty, and her perceptive discussion of the inherent irony of being taught that you can't take a patient where you yourself haven't gone, but on the other hand the real fear of crossing a boundary and facing judgment when you reveal too much about yourself to a fellow therapist, resonated with me. But that alone was not enough to negate my criticisms of the overall book, which still stand.

I do want there to be more books like this. If more therapists follow Lauren Slater's example, hopefully the range of quality will improve. Books like this can be a tremendous resource for therapists, and an area of human interest for everyone.

[Mary · Rating 2 out of 5]

Oh Lauren Slater! ((face palm)) What has she done with this book? I loved Lying: A Metaphorical Memoir. I adored it. Her writing was delicious and whimsical and daring and it was a swirling dream-like experience to read. And Prozac Diary was a fascinating and well written chronicle of the early years of anti-depressants.

What happened here?

She has the same beautiful prose and yet it annoyed me. Why?! Maybe she came across as condescending about her patients. Maybe she overly romanticized the schizophrenics she wrote about. Maybe she is just a little full of herself. Urgh!

[Jane · Rating 3 out of 5]

I've read many of Slater's essays over the years; this is one of her earliest works. Though she has some thoughtful insights as a new psychologist working with a variety of patients, her prose veers from elegant and rich to overly florid and fanciful. Also, at times here, as elsewhere, her raw emotional tone leaves me feeling a bit uneasy. It's more than "oversharing;" it's a question of boundaries that seem too permeable.

[Jaime · Rating 5 out of 5]

She brings such humanity to her work as a therapist and really captures the essence of her work.

[Steven · Rating 4 out of 5]

Well-written memoir of work in a home for schizophrenics. The author's experiences with these troubled people are fascinating and her frank and vivid prose is refreshing. The book is an excellent source of information about various mental illnesses. Until recently my hometown never saw unkempt homeless men wandering the streets muttering to themselves. Having read Slater's book, I feel like I understand these men better and can find some sympathy for their struggles.

My favorite part of the book was Slater's discussion of the "Word Salad," and the challenges that the schizophrenics face when trying to communicate. They want to talk, but for some reason all they can find is a random mix of unrelated words and phrases. Some sit and write all day, filling notebooks with page after page of unrelated words. Slater would review some of these desperate efforts to connect and sometimes find a single sentence or two that she could understand. But if she took it back to the troubled writer, would they be able to discuss it?

I bought this book when I read about it in the "Journal of Creative Non-Fiction." Unlike the men she once counseled, Slater writes beautifully.

[Alexia · Rating 5 out of 5]

A bit of the flowery language could've been toned down just a tad. Other than that, I'm in love with this book. Her experience seeing people with schizophrenia grapple with larger existential questions mirrors what I see at the hospital I work at.

[Amy · Rating 5 out of 5]

If you have ever worked in residential or with people who are underserved you will love this beautiful true stufff!!!

[Katie · Rating 4 out of 5]

She reminds me of Oliver Sacks, but with a feminine perspective. Really lyrical, human, and haunting writing.

[Elizabeth Gordon · Rating 4 out of 5]

Quick read, very well written. The author writes in a very poetic way, which can be great at times and at other times was over the top.

[Simona · Rating 3 out of 5]

A dispetto del titolo, Le stelle di Van Gogh non ha nessun nesso con il pittore olandese. Parla della follia e della pazzia spesso sintomi di creatività e di genio, come lo era appunto Van Gogh. Per certi aspetti, molto simile a L'uomo che scambiò sua moglie per un cappello di Oliver Sacks, anche questo libro di Lauren Slater è un viaggio nella medicina e nel rapporto che un dottore instaura con i propri pazienti.
Lauren Slater, da malata a terapeuta, instaura o prova a instaurare con i malati di mente, gli schizofrenici, un rapporto che sia il più umano possibile. Le stelle di Van Gogh è il suo percorso di psicoterapeuta a contatto con i pazienti. Le storie di Moxi, Marie e di molti altri ci fanno comprendere le loro patologie, ma allo stesso tempo la loro creatività, la loro follia e il loro genio.
Man mano che si addentra in queste storie, si scopre l'umanità, la bellezza dell'essere diversi e della follia in un rapporto intimo e accogliente che ci svela, ancora una volta, quando sia profonda la mente umana e le sue mille sfaccettature. Un altro modo per capire noi stessi, gli altri ed entrare ancora più in contatto con la nostra mente e anima.

[Ann · Rating 4 out of 5]

Slater's accounts of many of the chronically mentally ill people she's treated--both on a locked ward for schizophrenics and in a clinic. What's unique about her writing is that she reflects on what she recognizes in herself during her process of treating patients. At one point in her life, she was diagnosed as a borderline personality. She has suffered from anorexia and attempted suicide. She talks about how her experiences with pain influence her engagement with patients. She's an interesting writer. I am going to look into her other books (including _Prozac Diary_). The final essay in this book, "The Three Spheres," about returning to the psyc ward where she was treated as an adolescent to treat a patient. I had originally read this in a _Best American Essays_ collection, and it's still strong here, but even more so because the rest of the essays in the book lead up to this one, and the characters reappear throughout.

[Kelsey · Rating 4 out of 5]

I have to read this book for my Sociology In Deviance course, literally for a book review. We had to pick a book that was mentioned at the back of one of the chapters in our text book, and after the chapter in Mental Health, I picked this one. So far, it's intriguing, simply being let into a world of schizophrenics, what they truly see, and not what popular culture has defined it as, opens up my eyes to something I have never seen before. I see the world through their eyes, because it is in the perspective partially of the therapist, but also, you see the tension and stress she goes through when being new at this job and having to have group sessions with six schizophrenic patients, all male, in their own realms, pretty much. So far, it's an intense novel, I haven't gotten through it all yet, but I like it so far. It makes me look at something from a different angle, and fills me with curiosity.

[Ash · Rating 4 out of 5]

Welcome to my Country is a great book that effectively shows what it means to be diagnosed with a mental illness. It is nothing to be treated lightly. To do so would be insensitive. I was quite surprised on the author's use of descriptive language.

I am so used to doctors writing being so frank and succient that Dr. Slater descriptions surprised me. The stories were all heartbreaking in their own right. I felt bad for the schizophrenic who was once a genius and, could sometimes sense, what exactly he had lost and the depressed mother of two who is going have to endure a lifetime of perpetual depression just to have a few days of happiness.

Even Dr. Slater's own tragic past of abandonment and mental health illness was interesting as it showed an intregal part of how she treats and empathizes with her own patients. How can one person overcome their mental roadblocks and others remain stuck on the other side?

[Natalie Logue · Rating 5 out of 5]

A fantastic memoir about a psychologist and her experiences working in the dredges of the psychology world with long forgotten in-house patients, troubled out-house patients, and her own shaded past catching up with her. Lauren Slater takes the analysis of the unstable mind to the next level and really gets you to see her patients as real people, inviting you to take a look at the world through her eyes. The best aspect about this book is probably Slater's honesty in her own reactions and the condition of her patients. I really enjoyed reading this book through her voice and was even able to appreciate her experiences without my own prejudices effecting my perception - as much as that is possible. I would definitely recommend this to anyone who enjoys non-fiction and incredible writing.

[Gregory Levine · Rating 5 out of 5]

Couldn't put it down. Lauren Slater's prose is sensually, stunningly poetic. This book is charged with a joyful delight in foods and colors. At the same time, this is a tale of sadness and pain. Again, Lauren's words reveal the color and texture of terror, desperation, self-mutilation. But "Welcome to My Country" is much more than pretty words.

Dr. Lauren spins a web of self-revelation through her encounters with her psychology patients. It's spellbinding and endearing to watch her find, and reveal herself, in the most unlikely cases: the antisocial deviant, catatonic schizophrenic, and suicidal borderline personality disorder. In the end, her love for her patients is more astonishingly dazzling than her prose.

[Becca · Rating 4 out of 5]

While occasionally overwrought, Slater's memoir of her experiences as a therapist is mostly beautiful and moving-- a poetic exploration of severe mental illness. Rather than a technical manual, Welcome to my Country is rather a collection of short remembrances of patients whose struggles moved Slater on a level much deeper than doctor/patient. The ,most powerful in the final, in which Slater weaves in her own experience of mental illness. This memoir, and particularly in this chapter, is an emotional poem of illness, and Slater herself seems a powerful emblem of compassion and hope where little can be mustered.

[Holly · Rating 4 out of 5]

Really beautifully written insightful therapy stories of people with severe mental illnesses, including schzopherenia, depression, and conduct disorder. I love stories by therapists who connect with their clients on a very human level breaking down the fasade of doctor/patient and seeing the continuum of pain and beauty in everyone. The writer herself had prior hospitalizations for her own mental health before becoming a psychiatrist. She shares this openly and shows how it helps her to connect compassonately to her clients.

[K. · Rating 5 out of 5]

A sincerely poignant memoir of a psychologist who writes each chapter about a different mental condition and the "characters" in the early stages of her career. Not only is she perhaps one of the most gifted writers I've read, but she gets inside the very souls of her patients and expresses their pain in ways that only one who's been to those depths can. Slater is deeply compassionate in relating to her clients and opening our minds to the inner worlds of people with psychological disorders and emotional pain. Very enlightening!

[Kirsten · Rating 4 out of 5]

This is a fascinating and often moving account of a therapist's work with her clients, particularly the schizophrenic residents of a group home. The most moving chapter deals with her work with a woman who has borderline personality disorder and is also bulimic; treating her entails going back to the hospital where Slater herself was hospitalized multiple times for the same disorders, and the encounter is gripping and ultimately gorgeous.

[Anne Attanas · Rating 5 out of 5]

This is an amazing book for anyone who is thinking about or who is already in the mental health field. Burn-out is a huge concern among mental health practioners, and the author's prose demonstrates the love and kindness she has for her patients which is the ultimate source of healing. Lauren Slater's compassion and empathy shine through her words, which are that of a poet. I highly recommend this to anyone who needs to reconnect with him or herself.

[Eileen · Rating 4 out of 5]

Really liked this a lot. It is a tough read sometimes because of the difficult subject matter. I loved Slater's respect, compassion, and willingness to see things from her patients' unconventional point of view. Poetic. And no false hope or easy fixes, but little improvements where sometimes none are looked for at all. I liked how she brought her own experience with mental struggles / hospitalization in in the last chapter.

[M · Rating 4 out of 5]

Very wonderful insights into the real world of mental health from a clinician who has suffered from mental illness herself. The prose is beautiful, Slater's treatments eclectic, and the tone of the book very raw.

[Ryan Johnson · Rating 3 out of 5]

Well, surprise surprise surprise, what an outstanding ending. I've always said to my Supervisee's, never cry at work. What I mean by that is never cry in front of your co-workers, Crying however in front of Pt.s in entirely different and can be very effective. Great Ending.

[Leigh · Rating 4 out of 5]

Sometimes a little too self-consciously/obscurely poetic for me, but when Slater gauges it right (e.g., in the scene that lends the book its name), she's breathtaking.

[Mal · Rating 5 out of 5]

I read this years ago, have rec'd it, and given away my copy. I found it powerful, evocative, and memorable. Really worth a read.

[Augusta Dionysus · Rating 5 out of 5]

This may just be the most touching therapist memoir I've read, and this is saying a lot, since Lori Gottlieb's Maybe You Should Talk to Someone absolutely floored me. In this collection of essays, Slater contradicts commonly held beliefs in the psychiatry world, painting vivid portraits of her former patients as complex individuals with their own desires, sorrows, and longings. Perhaps the most touching detail is how she contradicts the once-common belief that schizophrenics do not experience complex emotions such as sadness and desire; her talks and activities with them reveal something much different: deep-feeling individuals with immense emotional capacities. Slater's close observation and ability to see inside patient's souls leads her to these discoveries, and whether she profiles a patient with schizophrenia, depression, borderline personality disorder, or her own inpatient experience, Slater touches on a universal experience within all of us, what it means to be human, and the longing we each possess for a phenomenon she calls the meeting of the self and self: the simple desire for our soul to be seen.

[Patricia]

Slater is a gorgeous writer, adept with language and image. The prose was more disturbing than I anticipated and I found it better to read early in the day as opposed to right before sleep or Slaters vivid writing slipped into my dreams. I appreciated how adroitly she told the story of patients accompanied by splashes of her own life, often included with poetic verve. Very unusual book. I'm curious to read her non-fiction work about Prozac.

[Dustyloup · Rating 4 out of 5]

Hauntingly beautiful, raw prose marred by fat phobia, over sharing patient/personal details and perhaps overgeneralizing her experience... But, dang, there are passages that punch the gut!

[Stephanie Spence · Rating 4 out of 5]

An exquisitely raw and poetic glimpse into the world of psychological healing—Slater’s voice is both fearless and tender, inviting us to witness without judgment and feel with depth.

[Alex Olson · Rating 3 out of 5]

Interesting and quick I just don’t think I like the autobiography + dramatically written descriptive novel cross over. Pick a lane.
BUT I did really like the ending and ✨reveal✨