Smoking Cigarettes, Eating Glass: A Psychologist’s Memoir

by Annita Perez Sawyer

"A fiercely honest and beautifully written book." —Paul Austin, author, Beautiful Eyes and Something for the Pain A cautionary tale of careless psychiatric diagnosis, treatment, and resilience Sawyer's memoir is a harrowing, heroic, and redeeming story of her battle with mental illness, and her triumph in overcoming it. In 1960, as a suicidal teenager, Sawyer was institutionalized, misdiagnosed, and suffered through 89 electroshock treatments before being transferred, labeled as "unimproved." The damage done has haunted her life. Discharged in 1966, after finally receiving proper psychiatric care, Sawyer kept her past secret and moved on to graduate from Yale University, raise two children, and become a respected psychotherapist. That is, until 2001, when she reviewed her hospital records and began to remember a broken childhood and the even more broken mental health system of the 1950s and 1960s.

Genres: Memoir, Mental Health, Psychology, Nonfiction, Audiobook, Mental Illness, Autobiography

310 pages, Paperback

First published June 1, 2015

Reviews

[Steve · Rating 5 out of 5]

Just finished reading Smoking Cigarettes, Eating Glass. A very good book on reaching for memories of an abused childhood and her recovery in following them. An inspirational book of extreme courage. "How do you find peace? Do you sit under a tree and wait? Will it come by if you are quite enough, like a deer or a hermit thrush invisible in the scenery, eventually revealing itself with the rustling that leads you to it?" I didn't want the book to end.

[Mary Jo · Rating 5 out of 5]

A teenage mental patient endures dozens of shock treatments that cause her to lose all her memories. Years later, as a psychologist herself, she uncovers her medical records, which leads her to rediscover the traumatic memories that triggered her collapse as a young adult.

One of the fascinating things about memoirs is the idea of reading a true story, of connecting not with a character, but a real person whose experience you can share. Sawyer takes us into the depths of the disturbed thinking caused by her illness and trauma. The beginning of the book is kind of hard to read because it's so upsetting to see someone treated this way by doctors and by her own mind. Later in the book, it's great to see Sawyer triumph over her illness and win professional and personal success. She makes a narrator who's easy to root for and care about.

In this kind of writing, the writer always has to make tough choices about which events to emphasize and which to leave out entirely, and those choices can never exactly meet up with the interests of all readers. I was interested in Sawyer's family life and her relationships with her patients, but the focus of the book was on her own journey of understanding her past.

Despite the intense subject matter, this story feels less raw than other memoirs I've read, almost sanitized at times. I think that difference is partly generational. Sawyer is a little older than the Baby Boomers, so she doesn't share that generation's extravagant personality. For example, Boomer Jeanette Walls also writes about her family's dysfunction, but the alcoholics in her family were a lot more flamboyant than the secretive ones in Sawyer's. Also, Sawyer's particular issues have to do with repression and dissociation, which naturally don't lead to wild tales of acting out a la Cheryl Strayed (a Gen-Xer).

This story is about the courage it took for Sawyer to analyze herself, to look at her former self the way she looks at her patients, with empathy and kindness. One message of the book is for those who work with the mentally ill, to be wary of misdiagnosis and projection. But beyond that, Sawyer writes with compassion about a lesson many of us need to learn at some point: how to forgive ourselves for what happened to us as kids. The ending of the book, as Sawyer begins to remember the truth about her childhood, is absorbing and disquieting.

[Alicia · Rating 4 out of 5]

To illustrate her entire point, when I first started this, I was like ‘wow, she was crazy’ but there was so. much. more. to it. Her thesis on psychiatric diagnoses being influenced by provider bias is so relevant, especially considering the detrimental effects of treatments on misdiagnosed patients. What an important read.

[Jason Pettus · Rating 4 out of 5]

(Reprinted from the Chicago Center for Literature and Photography [cclapcenter.com]. I am the original author of this essay, as well as the owner of CCLaP; it is not being reprinted illegally.)

Annita Perez Sawyer's memoir Smoking Cigarettes, Eating Glass is hugely typical of a type of book we get sent here all the time; a fascinating true story but from someone who is not usually a creative writer, most often published on a tiny press that exists specifically for these kinds of manuscripts, it's hard to deny that such books are immediately compelling simply from the spellbinding nature of the autobiographical tale they're telling, even as I'm forced to admit that the actual writing style of most of these books is only pedestrian at best. In this case Sawyer has put together a look at her youth as a misdiagnosed schizophrenic in the early 1960s, back when such conditions were typically treated with cruel and ineffective electroshock therapy and then incarceration into a "medical" facility that in the Mid-Century Modernist years was more like a prison, the hook here being that Sawyer grew up to be a respected psychotherapist herself, and was able to literally use her own medical records from her own youth to help change the way the entire profession now looks at the subject of bipolar disorder. As such, then, certainly this book is an enjoyable page-turner, and will hold a lot of interest for those who are grappling with these subjects themselves; but be warned that, typical of these kinds of memoirs, the writing itself is no great shakes, a manuscript that at least does the job of conveying the sentences Sawyer wishes to communicate, but that doesn't do much more than that. A recommendation today but a limited one, mostly to people who are already fascinated by this subject and wish to learn more.

Out of 10: 8.0

[Tallulah Willa Belle · Rating 2 out of 5]

I gave the book 2 stars because the author kept the reader at a safe arm’s length throughout the book. I do not blame her for this. She revealed a lot of personal information about her life to the whole world that few are brave enough to do in the name of self-healing, in the name of fighting the stigma of an illness so many people silently struggle with daily, in the name of exposing her truth and by doing so giving others permission to do the same. It is a harrowing tale. However, I did not enjoy the writing style or the undeveloped characters and relationships that were given glimpses into but not developed enough, leaving me wondering at the true depth of what the author describes in several occasions as the most meaningful relationships of her life. Particularly, the author’s psychiatrist from the mental institution where she spent her youth, who was her therapist into early adulthood was, I felt kept by the author as hers. Also, the relationship with and character of her next female psychiatrist, as well as the social worker the author next worked with along with her husband for marital counseling, the author’s husband, and her relationship with her children as well as a proper fleshing out and description of who these people were, details of their interactions that would have revealed the dynamics of the relationships, in general these characters were 2-dimensional when I a rich and deeply-rooted connection was described by the author to these people in her life. I do not blame the author for wanting to give the people in her life their privacy and a bit of ambiguous anonymity as they did not ask to be written about in a way that would have revealed a glimpse at their soul, what drives them, roots them, and connects them to the author in a way beyond the mere title of their relationship or a few brief descriptions of conversations or overview of their interactions. I wanted to know what needs were filled in these relationships. To me, the way we relate to one another is the reason we are here on earth. It is all that matters. The way we choose to interact with others on a daily basis and the slow development of bonds and connectedness to the world and people is fascinating. The author plainly felt at one time everyone and everything in the world around her were all flat, cardboard cutouts and that she was the only real being or perhaps she didn’t exist at all. Her dissociative detachment from reality that she described, makes the reader beg to understand how she related to and interacted with acquaintances, colleagues, even the grocery store checkout person, everyone throughout her life after feeling so alone and detached emotionally and physically from the world. I especially wanted her to flesh out the characters and relationships with those characters who she briefly gives the reader not teasing glimpses into but insufficient description of in terms of the relationships she states are/were the most important, influential, or close relationships she experienced.

I understand her reasoning for wanting to keep some relationships just for herself as her own, not to be shared with the world either as her private treasures or in deference to the allow the people in her life some privacy and anonymity. However, It left her amazing and harrowing story of her life, falling flat, 2-dimensional, and lacking authentic character development outside of herself which made her ability to develop relationships after suffering for so long from feeling the world around her was not real and that her existence could not have even the slightest effect on anything or anyone, feel impossible or not understandable as the reader as she did not document the slow progression. The transition from the author having the startling realization that her mere existence in room could have an effect on others, as was described beautifully during the interview with a visiting schizophrenic specialist at the asylum, to her ability to have deep, crucial, life-changing relationships with many people after her time in the asylum is not well documented through depictions, stories, details, or imagery of how she interacted with these different characters. It unfortunately makes the relationships and character hollow. Perhaps fictionalizing and blending together the attributes of multiple people who influenced her in her life into a couple actually authentic-feeling characters who, since slightly fictionalized, would have allowed the author to make the reader understand more of her journey to connect to the world and people in it. Perhaps she will continue to develop these necessary literary devices and build her literary muscles, as she is a novice writer, in order to serve the reader’s investment in her narratives and people in it. The content of the story is amazing. I just was sad that the execution left so much to be desired. .
Lastly, the author mentions multiple times she believes she was misdiagnosed in the asylum. I don’t doubt that, but I wish she would have further explored other possible diagnoses beyond trauma related dissociative disorder which is what I gleaned she thought her true diagnosis should have been although it it was never stated or addressed strangely. I felt there was perhaps more she didn’t wish to delve into there.

[Paul · Rating 4 out of 5]

This is a stark and sometimes upsetting story of the author's psychotic break in high school, and how she was misdiagnosed as a schizophrenic in the early 1960s and given more than 80 treatments of electro-convulsive therapy to ameliorate her supposed condition. As you read the book, you discover that what she really had to overcome is post-traumatic stress disorder. She's an excellent writer and describes her hallucinations and terror very effectively.

The only part I wish she had brought out more is the sex abuse that brought about her PTSD in the first place. She only makes three or four allusions to it and never specifically cites instances in which the abuse happened. Evidently it was her father; how long and how many episodes she suffered is left untold.

Her description of being cold-wrapped and then given ECT is reminiscent of Joanne Greenberg's I Never Promised You a Rose Garden. Her descriptions of being in the back wards of mental hospitals also shares a little with Frances Farmer's Will There Really Be a Morning?

[beth · Rating 3 out of 5]

everything felt flat, maybe because it's a memoir of a very dissociated life - but this made it sometimes difficult to get through.
unfortunately traumatised young people are still often misdiagnosed leading to incorrect treatment and extended suffering, although 50+ rounds of involuntary ect generally wouldn't fly anymore.

[Mary Latela · Rating 5 out of 5]

Smoking Cigarettes, Eating Glass: A Psychologist's Memoir by Annita Perez Sawyer ... Reviewed by Mary E. Latela

Annita Perez Sawyer has written a searing condemnation of her treatment as a patient in the mental health system beginning in the 1960s. Now a prominent clinical psychologist, she attests to the horrid system of private and state care in NY. She was given the "default diagnosis" for a suicidal young woman, namely, borderline schizophrenia, but that diagnosis was inaccurate. The treatment of choice was ECT, (electroconvulsive therapy) thought to jostle the brain with electric currents and thereby bring an end to the swirling thoughts and feelings, replacing them with numbness and memory gaps. She underwent 89 ECTs, an enormous sum, though her doctors recorded no improvement and in fact considered her treatment to be a failure.

As I read Dr. Sawyer's account I thought about the state system in CT where I grew up and worked, and the similar arbitrary collection of various patients treated with drugs in huge hospitals. In the 1950s the first wave of anti-psychotic medication – including trazadone – came out, with terrible side effects such as permanent tardive dyskinesia. Patient stays in mental hospitals began at a month for evaluation, but the meetings with actual psychiatrists were limited. The Ward nurses dispensed medication, watched over the units, and when trouble arose, called in the security trained workers who used physical restraint to "calm the patients."

After reading the initial section of the book with the terrible, frightening symptoms and Dr. Sawyer's absolute refusal to discuss intimacy, I speculated that her illness was hidden within her childhood. I was familiar with the symptoms, but she had no memory of anything unusual.

These days the large state facilities are closed. In the 1980s CT closed them to save costs. These behemoth old buildings housed – in different wings - elderly people with dementia like symptoms and special care needs; patients who were deemed to be criminally insane; the lifelong untreated bipolar patients; as well as the personality disordered.

Once the hospitals closed, patients were sent to live in apartments and houses in the community. I was an early trainee working with former patients making their transition back into the community. Unfortunately, many residents could not survive the daily routine, and longed for the safety and refuge of the hospitals. As residents were unable to cope with independent housing, they were sent to shelters where fears, symptoms out of control, and poor supervision caused many to leave. Homelessness was a lonely outcome for many.

Bloomingdale Insane Asylum where Dr. Sawyer was treated was a private hospital for the care of the mentally ill founded by New York Hospital. It occupied the land in the Morningside Heights neighborhood of Manhattan where Columbia University is now located.

Sawyer was accustomed to being "a good girl," so she complied with her doctors' orders, except that she felt she must die because she did not deserve to live. Her suicidal leanings led to extended stays, and even home visits were a nightmare. The family did not have counseling, as they might now, since Annita was the "identified patient." It was her illness that kept her family hostage. The theory of family systems has replaced this notion. A family and all the participating members enter into the makeup and function (or dysfunction) of a family. By blaming one person for "all the trouble," the problems of the family were not subject for discussion unless the patient introduced them.

Through her own determination, persistence in working with several fine psychitratrists, Annita improved. She earned advanced degrees, and worked through extended internships to become a bright provider of individual counseling. But first she read her medical records of which she had little or no memory. What she read became the impetus to tell her story, a brutally honest and sad examination of her struggle to come back to the community, to become the accomplished professional her teachers had always expected.

This is a courageous book of confrontation with a broken system, a haphazard approach to the rising incidence of mental illness, where individuals are trying to find wellness and meaning in spite of the inadequacy of care. Dr. Sawyer's colleagues to whom she lectured may have found her life story disturbing, but no one could deny her experience.

This is absolutely necessary reading for all professionals, and for all people concerned with the health of people as individuals and families in a hectic world. Superb work! Meaningful conclusions! Many thanks to Dr. Sawyer for her courage and excellent skill in communications.

[Princessdarcy · Rating 3 out of 5]

This book is both painful and hopeful to read.
I won’t diarize the ‘plot’ here because there are other reviews that do so.
You can feel the author’s pain and confusion and frustration, so much frustration as you read through the first section. The absurdity of how mental illnesses used to be treated is astounding!

I found reading about her and her husband’s conflict difficult because while I so related to her need for boundaries and her need to be alone and her detest for any sort of intimacy, I also felt badly for her husband who was basically wearing the brunt of what was happening. She does say he helped her where he could and that he seemed to be understanding but at the same time he seemed to take her situation and turn it around as something that was about him… for example in one part of the book he makes a gesture toward the hem of her tunic and she is triggered by fear and rage and his response is to sulk and demand to know ‘what did I do’ where it was already pretty clear at that point that she had serious troubles with any kind of intimacy or physical contact.

The hopeful part of this book is that if you just keep going, just keep asking for help, just keep believing that you deserve the help, you will find people along your way that WANT to help you, that want to care for you and that have the skills and ability to help you.

Also, I want to go to a Quaker Meeting! It sounds lovely!

[Tracy Anderson · Rating 4 out of 5]

This was a great memoir of a misdiagnosed psychiatric patient. It shows us how critical it is for Psychiatrists, Psychologist and Therapists to correctly diagnose their patients. This ladies life was seriously impacted by years of unnecessary Electric Shock Therapy. I really enjoyed how she was able to overcome many obstacles and become a successful Psychologist. The only reason I am not giving this book 5 stars is because the author never really reveals what her correct diagnoses is. Many of the symptoms she describes lead me to believe she might have Borderline Personality Disorder; however, since she never included this information in the book we will never really know.

[E J · Rating 4 out of 5]

Surprising, heartbreaking, clever and unexpected. I really enjoyed the way Annita teased the story of her life out with the narrative structure and reading about her struggling to cope with her own mental health even as she counselled others on their mental health problems. It was heartbreaking to read about all that happened to her, frustrating to experience the assumptions put on her by others, and horrifying to uncover the truth with her. But ultimately this is a story of hope, even in the face of life long trauma. Annita Perez Sawyer is an incredible woman who I admire greatly for her accomplishments and her persistence.

[Amy Morgan · Rating 5 out of 5]

Um, what a crazy, terrifying, heart-rending story. I couldn’t put it down. Ultimately, this book is one person’s story of childhood trauma misdiagnosed as schizophrenia resulting in fashionable treatment that caused further traumatization. Highly recommend to counselors and people who want to care well for the “severely” mentally ill—there are some incredible examples of the kind of compassion and care we should all aspire to. Potentially very triggering for abuse survivors.

[Anne · Rating 5 out of 5]

Sawyer's story is challenging, poignant, illuminating and, in many ways, triumphant. Never having experienced what she went through, I developed an appreciation for all who have grown up with hidden psychological pain. Sawyer turned her traumas into a gift for readers, who may go forth with more compassion and understanding of others. Other reviews give you the outline of Sawyer's book.

[marympinegmail.com · Rating 5 out of 5]

Eerie

This book really reached me. 1) by the generation was mine.2) I and my sister's have struggled with issues from our past. All of us dealing differently. At 58, I' m beginning to put pieces together for myself. This book made me realize and enforce my belief, that you can get past it with time....little at a time. Thank you.

[Meg Tuite · Rating 4 out of 5]

Was unable to put this down once I started reading. A woman who was misdiagnosed in the early '60s with schizophrenia, which was not uncommon at the time. Also, heartbreaking to read that she was given almost 90 EST and how they were administered during that period.
Amazing, how she comes through this. Harrowing and hopeful!

[Nita]

First heard of this writer via

http://blr.med.nyu.edu/content/interv...

and then discovered she is a fellow Yalie.

[Shelly · Rating 3 out of 5]

Very interesting - reminds me to put myself in the patient's shoes at work

[Medeya · Rating 5 out of 5]

Amazing outcome, disturbing because its based on someone's real life.

[Bonnie Mcintyre · Rating 4 out of 5]

Very good novel about mental illness.

[Tia · Rating 4 out of 5]

It's very easy to say oh, of course things were much worse in the olden days, but we're so much better now, and just disregard the central message of this book: patients, even children and adolescents, need to be listened to and met with empathy, not ego. The author's story may seem extreme, but I doubt it's all that rare. She was utterly failed by the adults in her life - her family, her psychiatrists and therapists, everyone.

The ambiguity of the author did not bother me. She does not portray someone as all bad or all good - often she doesn't seem to know herself what to think, which reflects her state of mind. It's true. It's not a failure as a writer.

The author's personality and actions, as submissive as they are, may seem even infuriating sometimes, but they make perfect sense. She has worked so tirelessly and honestly confronting her own past and even sharing this story, which must have been extremely difficult. Her story is an important - and timeless - reminder for all of us to stay awake and alert, questioning and compassionate.

[Alisonmsmith07 · Rating 5 out of 5]

I appreciate the courage and resilience Annita demonstrates while sharing her story. As a social worker and mental health counselor, myself, she gave a rare lifelong glimpse into the depth of the pain she experienced as a result of incest and what she did to try and cope. It is heartbreaking how the system failed her as a young girl but her resilience along with the care of dedicated professionals is hopeful . Thank you to Annita for writing this!!

[Lou · Rating 5 out of 5]

A beautiful book. Parallels between “you don’t look like anyone I know” include: only coming to terms with the trauma of one’s childhood after the parents who inflicted said trauma have passed. Annita’s memory lapses caused by shock treatments caused a similar disconnect from peers that Heather Sellers’ undiagnosed face blindness caused. In all of the otherness Annita described feeling in her memoir, she was always a very relatable character.

[Echo · Rating 4 out of 5]

Gave me insight

Insight into symptoms a child and a teenager in my life exhibited and how much meaning those symptoms might have. The book made me feel more empathetic toward behavior of others that I haven’t understood. Reading about the actual experience of the author was much better than reading about theory.

[Amanda · Rating 4 out of 5]

I had trouble putting it down

I choose this title, in all honesty, because i had a friend in high school who used to eat glass and cut herself (she also smoked, but who didn't). I became very invested in this woman and her misdiagnosis, and wondered about my own. Beautiful and heartfelt, needlessly wordy at times, but such is the nature of the beast.

[Brittany · Rating 5 out of 5]

Misdiagnosis to peace

This story took strength to live and share. As a psychiatric nurse I am always delving into memoirs and I am glad this one crossed my path. Her story started in the 60s but some things are still relevant to practitioners now

[anna dunkerson · Rating 5 out of 5]

Overcoming stigma one story at a time....

The book was excellent, well written, brutally honest, thank you for sharing your story, you may have saved a life, wishing you continued health and healing...

[Laurel Irwin · Rating 3 out of 5]

Not for the faint of heart.

Who am I to review this book? It was her life, it was what it was! I'm glad the author has come to some sort of terms with her childhood, but reading it has caused me real distress. It's depressing!

[Courtney Kindermann · Rating 5 out of 5]

Well written account.

Well written, in depth, and interesting. I enjoyed seeing Anita grow and overcome her early misdiagnosis. Her insight into the mind of someone who is suffering with mental health issues is great.

[Lise Lalonde · Rating 5 out of 5]

Fantastic read. Even though the experiences are often difficult to comprehend, it is also a testimonial of the human spirit. A very courageous and inspiring woman.

[Staci Baker · Rating 5 out of 5]

Couldn't put it down

Thank you for sharing your story. It was enlightening.
I admire your courage in the face of social stigma. Thank you.