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

by Norah Vincent

From the author of The New York Times bestseller Self-Made Man, a captivating expose of depression and mental illness in America

Revelatory, deeply personal, and utterly relevant, Voluntary Madness is a controversial work that unveils the state of mental healthcare in the United States from the inside out. At the conclusion of her celebrated first book—Self-Made Man, in which she spent eighteen months disguised as a man—Norah Vincent found herself emotionally drained and severely depressed.

Determined but uncertain about maintaining her own equilibrium, she boldly committed herself to three different facilities—a big-city hospital, a private clinic in the Midwest, and finally an upscale retreat in the South. Voluntary Madness is the chronicle of Vincent's journey through the world of the mentally ill as she struggles to find her own health and happiness.

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

304 pages, Hardcover

First published January 1, 2008

About the author

Norah Vincent was a senior fellow at the Foundation for the Defense of Democracies from its 2001 inception to 2003. As a freelance journalist, Vincent wrote columns for Salon, The Advocate, the Los Angeles Times, and The Village Voice. Her essays, columns and reviews appeared in The New Republic, The New York Times, The New York Post, The Washington Post and many more regional newspapers around the country. In 2003 she took a leave from writing her nationally syndicated political opinion columns in order to write her New York Times bestselling book Self-Made Man, the story of a woman living, working and dating in drag as a man.

Vincent held a bachelor's degree in philosophy from Williams College. Prior to her death she lived in New York City.

Vincent died via medically assisted suicide on July 6, 2022 at a clinic in Switzerland.

Reviews

[Leigh-ann · Rating 1 out of 5]

Not nearly as interesting as the premise suggests, and probably the only memoir I've ever read where the author exhibits absolutely no sense of humour. The book was as dry as dry can be. I think the book would have been more interesting if it really had been an outsider's account of life in a mental institution, but instead, the book quickly becomes an account of Vincent's own battle with depression. Speaking as someone who's suffered depression for the past decade, I can assure you that it's not particularly exciting or interesting.

I resent the author's continued suggestions that the mentally ill are ill of their own choosing, and that they've "given up" and are "spoiled" (the theory being, it's easier to be institutionalized than to be a contributing member of society). Vincent makes this assessment after spending a whopping 10 days (or fewer) with a handful of other mentally ill people in three different facilities. The author admits she can't battle her depression without Prozac, but also feels that overcoming her condition is all about willpower and "pushing through it". She questions the current medical literature which encourages the patient to feel that depression is a chemical imbalance and not an issue of weakness. According to Norah Vincent, people like me who suffer from depression of no apparent origin just need to suck it up :p

[E.D. Martin · Rating 1 out of 5]

Maybe I'm just as biased as the author, one of the "well-loved children of the upper middle class" - I majored in psychology, and I work with predominately indigent populations. So from the very start her disdain for psychological research ("I don't accept the terms by which mental illness is currently defined" - and your background is in what? Just because a layman doesn't understand or believe something *coughevolutioncoughglobalwarmingcough* doesn't mean it's not true) and for people seeking the best help they can afford rubbed me the wrong way. Sure, it would be great if everyone could retreat to luxury "bins" where the emphasis is on therapy, not meds. But what do you do with a population that has no money to spend and a budget that constantly shrinks? Oh wait, we throw those people out on the streets, or in state hospitals, where overworked nurses and therapists for the most part do the best they can.

I was so annoyed by her holier-than-though, I-know-everything-about-psychiatry attitude that I had to stop reading after just a few chapters.

[Cari · Rating 1 out of 5]

I'm doing this in bullet-points only, because if I go in depth, I will end up writing an entire book about a book that definitely doesn't deserve it. While there were moments where the Ms. Vincent made some very good points, this wasn't worth the time. It ended up being one of those books I had to read a chapter or two than walk away from, it irritated me that much. And truly, it wasn't the book itself that bothered me. It was the author and her attitude that I couldn't stand.

- People who suffer from depression, chemical dependence, or any mental illness are not guinea pigs! If an author chooses to use them as such for immersive journalism, she had damn well better do so with respect and compassion. The author has no respect for the vast majority of the patients she comes into contact with, as is evidenced by how she refers to them and their stories. Lip service is given to compassion, but it rings hollow. If you have compassion for your fellow patients, you do not help them break rules that are obviously there for a reason. (Example: you do not smuggle in candy and fast food for diabetics, nitwit!) You do not lecture your fellow patients on the evils of drugs. Yes, the patients should know the side-effects of their prescriptions. But medication is not evil (she even refers, in the conclusion, to the "evilly necessary" pill) and does, in fact, give a lot of help and hope to people who, without medication, are completely unable to function. Some people need those meds. Just because the author doesn't feel she needs them, doesn't mean she should be making the decision for everyone else.

- Mental health professionals unwittingly involved in research should also be treated with respect and compassion. Working in mental health, with such tragic stories, low success rates, incredible stressors, and a system that is too messed up to make it easier, is an incredibly difficult thing to do. The rate of burnout in mental health professionals is high to astronomical, depending on the research you look at. Especially in regards to the staff at her first stop, Vincent is incredibly disrespectful and harsh. Mental health workers are human, too, and they are in a field so rough it can eventually turn them into the one of the patients they previously tried to help. A little understanding on the side of the author, instead of hostility and condescension, would have been appreciated.

- At one point, the author refers to the "evilly necessary" pill. Aside from an awkward usage of the word "evilly," that pretty much sums up her approach to medication: pills are evil. Are medications often over-prescribed? Yes. Are they treated too often by patients and doctors alike as a one stop cure all? Yes. Are there side-effects that patients need to be aware of? Oh my goodness, yes. Do pills alone truly help a patient improve over the long-term? No. Is this a reason to dismiss them for everyone as evil? Absolutely not. Pills are not a cure-all by any means. Pills without intense psychotherapy do not put the patient on the path to recovery. But medication can give patients enough lift to start them down a very rocky road in therpay, not to mention give them enough relief to be functional on a day-to-day basis. Patients should always be aware of the side-effects so they can decide for themselves whether the benefits outweigh the risks. Doctors should most definitely be doing more to make patients aware of these risks, but also, in the end, a patient is responsible for doing the research if the doctor doesn't hand it to them. (I never start a medication without researching it intensely first. One Klonopin-induced seizure was enough for me. And ironically? The author has no problem singing the praises of Klonopin.) Some people need more help than therapy and hardwork can provide. Without the patient wanting to put in the hard work, the pills are pretty useless, I agree. But without the medication, a lot of people wouldn't ever be able to put in the effort and hard work in the first place. A lot of people wouldn't even be able to get out of bed. For an awful lot of people, psychiatric medications are an incredible blessing when taken correctly. (Another point: the author repeatedly stops taking her medication. She even does this at the end, when she states she is doing better. Despite the fact that she, and pretty much anyone on medication, knows how dangerous that is and how bad for you. And yet, she does it. Repeatedly. Could her blatant disregard for properly handling her meds have anything to do with why she hates them so much? Just a thought.)

- Immersion journalism, my ass! The sections detailing her stays at Meriwether and St. Luke's read less like a journalism project and more like someone desperately finding a "socially acceptable" way to check herself in. The author needs the help. She's obviously depressed, even in the beginning (you know, before this "research project" turns into "memoir"), despite her protests to the contrary. It seemed to me, instead of recognizing her situation as it stood, she had to find an excuse to check herself into a hospital. It felt like she had to find a way to make it palatable to her conscious mind without having to admit she was sinking fast. The third section reads like an extended advertisement for Mobius. I'm very happy that she found the type of environment she wanted, and I'm glad that at Mobius she got the tools she needed to help heal herself. No one deserves to be miserable. But the praises she sings for Mobius are over the top. Yes, there were major problems with Meriwether, and there were problems with St. Luke's. Just from reading, I can see problems with Mobius, as well, different from the other two yet still problematic, but the author abruptly dropped the bitterness and rage that drove her to find, detail and condemn lapses with the system when it came to Mobius. Freedom of movement and privacy are great, I can't argue that. But a lot of people in a hospital setting are not able to handle either - that's why they're in a hospital to start with. Just something to think about, as the author couldn't pull herself away from her own head long enough to consider that.

- This is petty, but it's a pet peeve of mine. The author repeatedly makes references, often literary, that serve no purpose to the narrative of Voluntary Madness. They're unnecessary and far too numerous, and it just felt like she was trying to show how smart she is. For the most part, her writing was fine, and she's obviously an intelligent and articulate lady. But waxing poetic and going on about "Lear's fool" or "self-styled Hamlet" is unnecessary and self-indulgent. (And the Shakespeare references? Are just the recognizable tip of the iceberg.) References are fine. Too often, these sorts of literary or historical references were the starting point for indulgent musings written in purple prose. They got old very fast. Otherwise, her writing was very crisp and to the point, blunt and easily accessible.

I think if this had been a memoir of the author's own experience from front cover to back, I wouldn't have been nearly so irritated. She freely admits in the opening that this turned into a documentation of her own struggle by the end. That's fine. But don't market it as the work of a journalist when it was written by the depressive. And if you're going to rip into a system so harshly, tear it apart and condemn it, then you'd better have some damn good ideas on fixing it beyond "give the patient a hug." The mental health system is lacking and is far from perfect, but it's all we've got. Places like Mobius are far out of most people's financial capabilities, even if their insurance did pay for most of it. Even St. Luke's is more expensive than a lot of people can handle. Good medical care is astronomically expensive, and this needs to change. But spitting and screaming and tearing everyone to shreds does nothing. Expose it, but then put forth some suggestions, as someone who has been on the inside, on how to change things. It's not the author's responsibility to fix it, but she should know that a temper tantrum doesn't help anybody. And this book? Was mostly one big temper tantrum.

[Nicole · Rating 1 out of 5]

This was an incredibly difficult book to read. If I had to narrow down the long list of adjectives for the author that crossed my mind as I read, I would have to put "loathsome", "arrogant", and "unprofessional" at the top of the list. Vincent had zero objectivity and a definite agenda going into this project-- to prove right all her theories about mental illness, the evils of medication, and the incompetence of doctors. These were, of course, theories based on her own bad experience with a mental hospital and the undocumented research she did to support her viewpoint.

So she looks down on and insults everyone, from the doctors and nurses who were too run down by the system to care for patients who seemed beyond help, all the way to the people she admits actually helped her and seemed to genuinely care. She gives people offensive nicknames, recounts her own insulting dialogue, and at one point tells other mental patients, history unknown, that the medication being prescribed to them is dangerous and might harm them. That's just irresponsible, no matter how much you think you know.

Vincent rips on the inefficiency of psychiatric medicine, making wild claims that she doesn't back up with evidence, and claiming that it has ruined her life-- but gosh, when SHE needs it, it sure does help, doesn't it? At the very end, I found the fact that her two-week stay in the hippie facility cost half of what the ten-day stays in the other hospitals cost interesting. She doesn't delve deeply into where the funding for any of the facilities comes from, or what states they are in, so even this conclusion suits her predetermined agenda.

This is an unpleasant, difficult woman and I'm sure her stays in the hospitals were awful. She wanted them to be.

[Brittany B. · Rating 5 out of 5]

I read this right when it was released hardcover- so it was a while ago. Ive been trying to remember the name of this book so I could add it, and it just came back to me. (brilliant that I didn't think to check my actual bookshelf)

I read the reviews others wrote and was very surprised how how low the ratings were. I was fascinated with this memoir, for both personal and objective reasons. The author has a mild to medium level of mental illness throughout her life. When this memoir begins, Norah Vincent had recently finished her memoir on living life as a man (temporary, not a transsexual). After that book, Ms Vincent became very depressed and decided to get mental health care in a facility. All of this is quickly laid out to explain that the memoir will chronicle her life as she gets mental health treatment and struggles with a life of illness, medications, and hopefully recovery.

It was fascinating, depressing, inspiring and important. She goes through 4 facilities, I believe. One state facility, one high price facility. I don't remember the other two. She chronicles what it's like to be sick and in the various hospitals.

Having experience with loved ones in mental health facilities, I was also experiencing a personal crisis while reading this book. It was incredibly valuable to read Ms. Vincent's experience. She actually was having major depression and a difficult nervous breakdown. I want to point out that I ABSOLUTELY do not believe she faked a single moment, nor did she took advantage of the circumstances for the purpose of sensationalism.

This is a novel that stuck with me. I highly recommend it. This memoir speaks out about the how easily a person can spiral into mental illness and about the nature of state-run vs private health care facilities. I don't feel this author had a political agenda, I'm LOATHE to that type of nonsense. But reality is what it is.

Also, it was fascinating to learn the various ways of treatment. Why do some patients lose themselves to illness, yet others overcome even the darkest abyss? What is it like to stay at a chic "wellness" clinic... And what is it like to get stuck in a state facility.

Again, I read this about 3 years ago so maybe I'd have a different perspective now. I will flip through it again soon and revise this if neseccary. Otherwise, I admit that I still think about things I learned from this memoir.

If you're interested, don't let bad reviews change your mind. For some, this may be incredibly useful.

[Howard · Rating 5 out of 5]

5 Stars for Voluntary Madness: Lost and Found in the Mental Health Care System (ebook) by Norah Vincent.

This is one of the most depressing and disturbing books I’ve read. I’ve already read Self Made-Made Man and I really like the author’s insights on what life is like being a man. But I also knew that she had taken her own life and I thought that this book would help explain that decision. It was hard listening to the author describing her experiences in the mental health facilities and knowing how ultimately it would end.

[Kavita · Rating 2 out of 5]

I can only come to the conclusion that I am arrogant. I had Voluntary Madness on my reader for a long time. Before reading, I looked up the reviews. Almost all of them suggested I should skip this one. Yet, I thought I would get something out of it. Silly me! Vincent has a sole agenda to push in the book, and worse, she doesn't even do it well or interestingly.

The premise of Voluntary Madness is to describe the functioning of three American mental health facilities, or loony bins, if you prefer, as the author obviously does. The author's sole aim is to discredit these institutions and the mental health system. But her agenda also includes discrediting medicines completely, even while she herself is on them. All of this is fine, as I am sure this is a topic that needs to be talked about much more. But can we dispense with the whining, please?

First, Vincent visits a public facility called Meriwether in the guise of a patient. There, she meets a number of vagrants who are in because they are mostly court-mandated. Their main problem is not their mental health, but their financial health. These are the people who have absolutely no hope for recovery, because they can't afford the time, effort, peace, or resources. I was extremely bored with this part because the woman goes on and on about vomiting and spitting and people shitting themselves.

In the second facility, St. Luke's, a private but traditional facility, Vincent finds a much better system. The staff is more caring, but this does not prevent her from tearing them apart. The people are mostly white and middle class. The third facility is Mobius, which follows a more therapeutic approach to healing. Only privileged people come to Mobius, and they don't appear to have severe psychotic issues unlike those in Meriwether.

I glance read through most of the book. Since the book started with Meriwether and a bunch of food dribbling and shitting episodes, I decided I wanted no part of this. I was looking for something more interesting. It never came. Instead, what I got was Vincent's pseudo-scientific rubbish, her unshakeable belief that it is not medicine but hugs that everyone needs, and that other people (patients or staff) are all horrible.

The descriptions of life in the 'loony bins' were decent enough, but far too frequently, Vincent goes off on long tangents about the use of medicine, the apathy of doctors, the corruption of big pharma, and she ends up philosophising endlessly about these issues throughout the book. I personally think that the book could have been nicely wrapped up in half the pages and it would have been much more interesting. I don't think Vincent's ramblings holds much interest to anyone. Her writing is also pretentious very frequently with rambling sentences and literary hints thrown in for good measure, all adding to the word count, I am sure.

Midway through the project, Vincent also falls into depression herself. Much of the screen time then goes to her ramblings about her own problems and her therapy and medical experiences, all of which were of the least interest to me because I had already started to dislike her thoroughly by then. She also advocates the inevitable 'buck up and cure yourself' routine for depressives on a regular basis, so much so that I wanted to take a huge stick and beat the crap out of her. If she really believes this, why go on meds and enter mental hospitals? Why not just go fuck yourself? We readers would all be spared the annoyance, at least!

[Courtney · Rating 1 out of 5]

having read her other book and being in the field of mental health, i thought this would be very interesting. unfortunately, the author was under the impression she was objectively evaulating the sytem that treats mental illness but she was actually depressed and dealing with some deep personal issues at the time she tried to do this. it also seems that her background on the topic is woefully uninformed, so instead of being a fascinating new look at the topic, it was just one person's very biased description of hospitalization. there was an odd combination between vincent distancing herself from the other patients as an objective reporter (which was not completely accurate) in the beginning followed by her relating her own personal experiences with depression to the whole of mental illness, including patients with schizophrenia (which is so very obviously not accurate). furthermore, in her summary at the end of the book, she seems to confuse the idea of mind and brain to the point that she proclaims that someone's will, if strong enough, can cure them. she talks about ways of restructuring her beliefs, which may be fine for a person with mild depression related to life stressors. but she writes as though this would also apply to people with severe mental illness. i wonder if she also believes that people should will themselves healthy when diagnosed with alzheimer's, aids, and multiple sclerosis. although the concept of the book is fabulous, the process and conclusions were quite disappointing. i do think it was an important read for knowing just what the general population's misunderstandings about the field are and where they come from.

[Robin · Rating 4 out of 5]

As a therapist, I put aside my defensive feelings during the first part of the book when she sounds and seems very angry and aloof (and later admits to that). I still think it is absurd to hospitalize yourself if you don't need it, and most people do know that the hospital is not a place for treatment but for safe stabilization. Otherwise, if you take this book for what it is - one person's journey through her own personal struggle with depression - it is a valuable read. I definitely believe that everyone does have to be in the driver's seat in his or her own recovery from any mental illness. Some are unable to do so, temporarily, but in the end true healing will only come when that is in place in my opinion. That is the way it should be - that a person be independent not dependent...so I agree with her message. Even though she often sounds angry, opinionated and downright mean, that is taken by me as the voice of someone with depression. That did not make me discount her words, however. There are a lot of terrible doctors and therapists, just as there are terrible teachers and preachers and everything else under the sun. That is the main reason that we all should be selective in choosing our own helpers, when we can. In short, a thought-provoking read for me....not so much "really liked," but really intense and thought provoking.

[Mic · Rating 1 out of 5]

This book is terrible. I enjoyed The Self Made Man because, though I thought it was an unoriginal premise, it was highly insightful. This piece of garbage lacked everything I liked and had come to hope for from Norah Vincent. Despite immersing herself in "madness" she shows no understanding of mental illness, both of her own and that of others. Her clumsy attempts at probing her own psyche just come off as incredible self absorption, and her comments towards others are so astoundingly superficial I'm surprised she's even aware that other people are in the room with her.

Truth be told I used to work in a mental institution, which is why I was looking forward to reading this book, and why I was so disappointed.

If you are crying because you see melting demon faces in the shadows and you feel like there are gnats crawling out of your orifices at all times , I have sympathy for you and patience for your dysfunctional behavior. Depressives that just lay in bed all day and blame everyone else for the way they feel-- they irritate the crap out of me. Three hundred pages and a year later Norah learns that, as opposed to her compatriots who suffer from real, debilitating chemical imbalances and frightening hallucinations and delusions, she needs to stop waiting for other people-- the professionals she disparages for 300 pages-- to fix her and needs to do some of the work herself. No shit.

I really hope she finds time to crawl out of her own ass before her next book. I really did enjoy Self Made Man. Let’s see some more of that
.

[Lain · Rating 3 out of 5]

To start with, I admire Norah Vincent's willingness to throw herself completely into her research. Following on her year of living as a man, she spends several weeks at three different mental institutions. No denying the fact that she is willing to sacrifice for her work!

Her descriptions of being housed in the giant metropolitan hospital are harrowing, as are the pictures she draws of her fellow mental patients. She is an apt observer and captures the telling detail (a list of pseudonyms a patient writes for her in thick magic marker on a page torn from a book because they are allowed neither paper nor pens).

But her role of observer is compromised by her own mental history -- she's been treated for depression and has a pharmacological past checkered with a variety of drugs.

As a result, this book is neither this nor that. She can't be an impartial observer, but she attemtps to be, at least initially. She can't adequately compare and contrast the treatment she receives because she second-guesses her first doctors, and doesn't fully "participate" in the program as she does at Mobius, her third stay.

I also found it interesting that while Vincent insisted on the necessity of revealing her deception in her first book (posing as a man) she never "outs" herself to patients or staff in this book. Curious.

All the same, this book provides an important critique of mental health care in the United States. It's encouraging that places like Mobius exist, and it's sobering (no pun intended) that the "Cuckoo's Nest" still exists.

[Shai · Rating 1 out of 5]

Oh man, finishing this was a bitch. I wish I can give this book -5 stars if I could. Awful. Very awful. I hate this book and I've never hated a book before in my life.
This book is basically a huge fuck you for anyone working in the mental health profession. Even though, I am not one YET. I was extremely offended by everything the author had to say. I have interned in a psychiatric hospital for two months and let me just say, the system is not perfect, but whatever she says about how MHP do not care about patients is bullshit. Her book is filled with hate towards them and I don't even understand why.
The author is extremely obnoxious and pretends she knows better. I am sorry if you went through hardships, but seriously you sound ignorant and so god damn bitter. The last chapter was very hard to read (I literally just finished the book and I'm extremely annoyed).
I highly doubt the author did any research on mental illnesses before she wrote this book. Or perhaps she attended psych 101 and she pretends she knows the psychopathology of mental illness.
Y'all don't waste your money on this. I'll gladly hand you off my copy. If I don't end up burning it.

[Cecily - MillennialBookGal · Rating 3 out of 5]

An interesting perspective on mental health institutions and how they are not the cure all that people think that they are. There was a time in my life where a stay was suggested but then minds were changed as they truly believed pulling me out of real life to deal with my issues was never going to work long term. I am glad that this was the decision that was made because, as this book also explains, you must do the work, no one else, or no medication can change your situation. It is hard but it is worth to know that you have that kind of power.
Decent read but nothing really profound.

[Nette · Rating 1 out of 5]

My friend Nancy's mom drummed into us that we should NEVER say that we hate anyone, so I'll just say (through clenched teeth) that I found this book insulting and pretentious, and that I disliked this author very, very, very, very much.

[Kelly · Rating 3 out of 5]

"You don't see things how they are. You see them as you are."

Crawling out of your skin, hyper-aware of every thought that rides in with the waves and all but screaming out loud for it to stop as you search every available medicine cabinet, internet chat room and available body in the single hope of escaping. Escape from the despair, the anger, the loneliness and the all-consuming fear that seems to pervade this moment.

More and more I'm realizing that everyone has those moments, days, thought patterns. All of us, at one point or another in our lives, is Susanna Kaysen or Lisa Rowe; Struggling against yourself, your life and the desire to give up or get on is all you can manage to focus on. If you're lucky the moment passes, the stressor resolves itself, and you move into the next moment unaffected as the other becomes a surface memory. For others, as Ms. Vincent has clearly shown us, it's a battle that must be fought every minute of every day.

Ms. Vincent's Voluntary Madness was very informative and did bring me a deeper understanding of the medical community and mentally ill, as well as shed light on chemical dependency. Unfortunately, while it may have started out as a journalistic approach, it clearly develops into a memoir... and that's where my own issues with the book began to develop. Subjective, overwhelmed with her own manic state, Vincent never really embraces the process and therefore, never truly takes in what the facilities have to offer nor what the synopsis promises. How could she when she went in already against the system, the faculty, and the treatment process. In fact, Vincent keeps her distance rather than participate at the first two institutions and instead condescends almost the entire time. It was only at Mobius, the third facility, that Vincent allowed herself to be open enough to learn about her disease and relate those findings to the reader. A facility, by the way, that matched the idea of what she perceives as being a truly "healing" center.

So, while this was supposed to be an objective collection of information regarding mental illness, it turned into Vincent's own personal platform which she abused with her own personal opinions/rants on the medical community, pharmaceutical companies, corporate America and middle class Americans. Not to mention her insistence that she believes that most mental illnesses, if not all, are self-induced due to weak, lazy minds and a desire for a quick fix....as she pops her Prozac throughout.

[Laren · Rating 2 out of 5]

The author calls herself an immersive journalist, and the idea for this book came to her during her treatment for a nervous breakdown at the end of the research for her last book. She would voluntarily check into several different residential mental health facilities, expose their differences and try to make the correlation with their success rates.

From the start it is clear that the author is already against psychiatric meds, and in the first facility, a public one primarily treating patients with no insurance, it seems she has already made up her mind what she will find during her journey. I began to be cranky that I had bothered with such biased journalism, but I kept reading. As it turns out, the book she published is not the one she thought she was going to write. For one thing, she predictably falls into a real depression during her research, as with the last book, and this book ends up being more about her journey out of that depression using the varied tools that the varying institutions try to arm her with. And, oh yeah, it turns out she needs a little of those meds after all.

I loved her liberal use of advanced vocabulary and how she was able to change her mind a little along the way. I didn't like the liberal use of profanity or the bait and switch concept. Perhaps this book would be inspirational to someone struggling with their own depression. But unintentionally, it also can cloud a mood-stable brain into some dangerously depressive thoughts too. Read with caution if her journey interests you.

[Carol · Rating 4 out of 5]

This is book 2 in the best of contemporary immersion journalism. Vincent's first book was "Self-Made Man", in which she passed as as male for a whole year, through experiences of work, sports, dating, etc. Eye-opening, to say the least. This time around she gave herself the task of infiltrating America's mental health institutions. There is no love lost here for the people who run these systems. So perhaps all of our various and sundry mental health workers SHOULD read this book. She was actually admitted to three different institutions, all under the diagnosis of depression, and all with varying results. The first was state-run, mostly hardcore drugs and schizophrenia with very little actual help. The second was midwestern small-city, and the third very contemporary new-agey rehab type. Throughout her actual immersion in these scenes, Vincent goes in and out of some actual depression, and goes into some pretty graphic roots of depression and violence. By the end, I can say I was actually, well...pretty depressed. But her journalism and her journey are valid and vivid. The takeaway: "Normal life is nuts. It's a downhill deterioration to death....It takes a lunatic, or someone functioning with the critical apparatus of a worker bee, to keep scrabbling up that hill when he know his destiny is dust. But that is what is required. Go on."

[Anderse · Rating 1 out of 5]

"We are pack animals and heliotropes all, bending toward the light, the open, the air, dependent on it, even as we bemoan the constant flux and injury to which free will and society subjects us." page 196

If the above passage appeals to you, then by all means read this book. It's your life to waste. I almost put it down but I foolishly thought something exciting might happen at the end or at her third facility. Sorry - I should have said "bin" as she repeatedly refers to all of the hospitals and clinics she goes to.

This is not journalism about "the bin" - it's a self involved diary of her FEELINGS filtered through freshman psych 101. It's not journalism at all. Or self help. I don't rightly know what this book is but what it isn't is good.

[Petra X · Rating 3 out of 5]

Yet another book that I added to my shelves and read and rated that has disappeared. I can't remember if I reviewed it or not. Edit This evening I found another book this is missing, Blood, Bones, and Butter: The Inadvertent Education of a Reluctant Chef. It's mystifying and worrying.

I used to export my books regularly but always let the file overwrite the old one. Not any more. Since last June when I started to notice books and reviews going missing I've been keeping them all.

The only time in the past I could actually prove I had a book that was now deleted, GR told me that I must have deleted it myself. Now why would I do that? But of course, it's impossible to prove that I didn't.

I used to have a bit of a problem with customers using my machine as well as the public machines, or I had used a public one and left myself signed into GR. I was entered for a giveaway (I think it's tacky for booksellers to try and get free books) by someone, someone else wrote a very rude letter to a very rude Super Librarian/GR Mod, people I'd never heard of were added to my friends' list. So I suppose they could have deleted books or reviews. But I've been very careful about that the last few years and usually sign out.

So what could it be? How could books and reviews be deleted? Is it to do with Librarians? Is it Amazon overwriting, is it GR? Why doesn't GR even care?

[Cynthia · Rating 3 out of 5]

This starts with a great premise - after having been admitted to a pscyhiatric ward for depression, the author decides to research three other facilities while "in cognito." One is a public facility in apparently NYC, another a private faciltiy somewhere in Midwest USA and last an alternative treatment facility that is also privately funded.
Where the book loses some of its punch is when the author decides to go off her prescribed Prozac and becomes truly depressed herself. Thus instead of revealing the lack of care and caring in the three facilities and/or opposite of, the book becomes about Norah's depression and consequent "recovery" and acceptance of. This in and of iteself would have made an interesting story but it is not what is promised. Being a nurse and having worked in government and privately funded psychiatric facilites, I wanted to hear more about the people who work there and the clients. Especially in the first section where Ms. Vincent is admitted to the public hospital, the book is interesting and revealing. The people are both tear-wrenching and hateful in equal turns (ataff and patients.)It is a sad and mind-numbing place (literally and figuratively) and revealing in the treatment or neglect received by the patients. Where do the indigent and "mentally ill" go when their time is up in a mental facility? Why can't the public accept and make room for them? Will the stigma of mental illness ever be vanquished? I wish she had kept more to this tone and I would have liked this book better. It is a beautifully crafted book. Ms. Vincent, you are a great and interesting person, next time write about yourself and your own journey. I would read that in a heartbeat. Don't promise something else instead.

[Liz · Rating 4 out of 5]

I like Norah Vincent, but I bet her next book will be "How I Committed Suicide." Because she does stuff that one wouldn't normally do, and it usually ends up coming precariously close to destroying her. In her last book she dresses up like a man and lives in society as that (dating, working, etc), and in this book she commits (committs?) herself to various mental institutions, to see if money/class matter in the quality of care you get. And, it does.

What I like about the author is that she is very honest and makes it perfectly clear that she is, in fact, an idiot when getting herself into these situations. I also like how she describes how the cycle of depression and drugs that we don't know much about feed off of each other.

It's a quick read, and interesting, but mildly disturbing (if you've ever taken any drugs or been to a counselor. Or if you know someone who has). I like how she is matter-of-fact, I don't love her attitude in general...I can't describe it better than that. It's something different.

[Sarah · Rating 2 out of 5]

Part of the reason the book gets such a low rating is that I did so much work in mental health during my undergrad. Norah is deceitful and that makes me upset. I don't like to be tricked. While I do think that the workers in some of the hospitals were just lazy, I feel like her book is more a reflection on how our mental health system is underfunded, unappreciated, and misunderstood. This book was written to 'shock and awe', and it meets that goal.

This book breaks my heart and makes me uncomfortable in my own thoughts. It isn't pleasant to see what happens in some institutions. I have trouble beliving some of what was written, that the author took creative license. And, she herself writes that she felt herself slipping away into madness. Could not those feelings have tainted her notes, memories, and perceptions of the events she records from the institutions?

I really don't recommend the book to anyone except someone who wants an alternative perspective on the mental health system in the US.

[Jamie Moesser · Rating 5 out of 5]

I read this book to do research for a fiction book I'm writing involving life inside a mental hospital. While I got plenty of details for that, I also got some things I didn't expect, like the embrace of a haunting and sharp-but-sensitive style and prompts for deep thoughts on the way severe mental illness has touched my life and on the way our society handles it. Both of these things made this book an unforgettable read for me.

Voluntary Madness is the book Norah Vincent didn't intend to write, and even when she did write it, it didn't bear out the truths she set out to expose. Before writing it, she wrote another one called Self-Made Man, for which she immersed herself in the life of a man she created, posing as that man for a year and a half. But such immersion brought on some mental issues of her own that she'd dealt with before, and some she hadn't, and those issues came to the forefront in a way that demanded she deal with them in intense therapeutic confines. She got herself committed to three: the psychiatric ward of a big-city public hospital called Meriwether (not its real name); a well-funded rural private hospital that accepted only insured patients; and a private clinic called Mobius.

She went into the first suffering ostensibly from depression, although not at clinically low levels. She posed as someone with vaguely suicidal thoughts, and was easily admitted, intending to expose the faults of state-administered treatment of severe mental illness and the effects those faults have on the hapless sufferers of those illnesses. What she found was a situation far more complex than she thought it would be.

About the public hospital, for instance, she notes:

This is the paradox of asylums, and their fatal flaw. Put a person in a cage and you cannot help him. But leave him to his devices and he cannot help himself, or will not. Freedom is a prerequisite for a healing a broken mind. It cannot be fixed against its will. Yet a broken mind is a broken will, a freedom that does harm. So, how else to heal but by force?

Most of the patients Norah got to know in Meriwether were repeat visitors who were, as she said, "like the rest of us," just more trapped in the problems of their minds and the chicken-and-egg cycles of dysfunctions caused by those problems. The staff seemed to be the stereotypical apathetic bunch, intent on doing only the bare minimum their jobs required. But by the end of her stay, she felt sympathetic towards them, having to deal with patients who perpetually seemed to infantalize themselves and take advantage of others.

The complexity of the issue and the people involved only became more evident during her stays at St. Luke's, the rural private hospital, and Mobius, which were both much more luxurious by comparison and staffed by more caring and knowledgeable staff. St. Luke's still relied on heavily medicating their perpetual patients, and Mobius, though focused entirely on progressive therapy instead of medication, still came up short for those patients who "took refuge in their diagnoses, which absolved them of their responsibilities," or fought healing for reasons known only to themselves.

Indeed, it became apparent that the deficiencies of the mental health treatment system in the U.S. are, at least in part, a result of 1) a lack of knowledge of exactly how to treat such profound illnesses, ones that can affect every aspect of a sufferer's life, thus making it impossible to tell what part of a person is the mentally ill part, and what is the part that might just be in denial or missing some key life or interpersonal skills, and 2) the fact that, while there are enough commonalities in the symptoms of various mental illnesses to merit the inclusion of certain diagnoses in the bible of psychiatric disorders, the DSM-V, there are also so many different ways in which those illnesses manifest themselves in individuals that the difficulties in treating such a wide variety of manifestations seems apparent.

This isn't to say that the patients themselves are at fault for the inability of the system to rehabilitate them, but a recognition of the fact that some patients are harder to treat than others, both because of symptomological complexity and their resistance to treatment. "The people in St. Luke's," she says, "consumed their depression, rolled in it like pigs. We were all so eager to decline responsibility for everything, to recline in the arms of a disease and quit, to take our failures, our gloomy, angry view of the world and make it into a fortress against that world."

This book answered a question I had had in the back of my mind for years about Greg, the paranoid schizophrenic man upon whom the fiction book I'm writing is based. He's been in and out of a state psychiatric hospital and various prisons for years, and when he's out, he sits on the front porch of his shanty and flips off the drivers of every other passing car. He caused significant problems in our neighborhood, urinating on churches and the like. But yet, he's a friend, one my husband has known since junior high, when he was sane. I've wondered if the system failed him, but I suspect now that it's more a matter of his resistance to the system, the persistence of his disease, and the deficiencies in knowledge of what actually causes mental illness.

Vincent infuses her deep exploration of our mental health system and its occupants with a style I've not found in many other non-fiction memoir books, especially those in the vein of mental illness or neurological disorder. She says, for instance, "The people in St. Luke's...consumed their depression, rolled in it like pigs. We were all so eager to decline responsibility for everything, to recline in the arms of a disease and quit, to take our failures, our gloomy, angry view of the world and make it into a fortress against that world." It is this style, this "writing between the lines," that made the truths she exposed, not only about the system but about herself as well, that made this book resonate so deeply with me.

What stayed with me the most, though, was a question she asked at the end: "We are pack animals sustained by companionship...and our position in the web of human contact. What about a community that makes a place and takes responsibility for the impaired, accepts them as part of the larger civic body and takes the burden on itself, spreads it among the healthy to lighten the load? What about a community that says, 'We will care for our own?'" To that I would add, somewhat tangentially but as a manifestation of how I hope my reading of this book will improve not only my writing but my course of action to help my family and community members who deal with mental illness: "What about the community supporting people who are trying to take of family members with severe mental illnesses, or people that have friends with severe mental illness, so that they are enabled and empowered, rather than relying so heavily on a system that is, in the end, only populated with 'people like us?'"

[Emily · Rating 5 out of 5]

A lot of people have disliked this book because it was "in no way humorous." Did they read what it is about? Of course it's not funny. Despite Hollywood's take on the subject, mental hospitals are NOT funny. They're terrifying, lonely, and sometimes dangerous places to be. This book is a great book illuminating a side of the mental healthcare system that is rarely seen-and when seen is discredited because the people who see it must be "crazy." While what she did was very dangerous, I applaud her for trying to show the truth to the world-mental hospitals are not as safe as we would like to believe.

[John Hood · Rating 5 out of 5]

http://miamisunpost.com/archives/2009...

Bound Miami SunPost Jan. 1, 2009


Crazy Lady

Norah Vincent Hits the Loony Bins

By John Hood


When former Los Angeles Times columnist Norah Vincent decided to live life as a man for a while, she probably had no idea the experience would produce a bona fide bestseller (Self-Made Man), or that the living would literally drive her nuts. But 18 months later, after a total immersion that included joining an all-male bowling team, hitting the strip clubs and dating other women, she lost it, and, at the advice of her shrink, checked herself in to a loony bin.

Actually, Vincent was so taken with the accommodations, she checked into three different psych wards over the course of a year and decided to make her stays the basis of her next bout of investigative immersion. The result: Voluntary Madness: My Year Lost and Found in the Loony Bin (Viking, $25.95), a work that dives as deep into America’s mental health care conundrum as it does into Vincent’s own mental health, which, as you might suspect, is far from being the picture of perfect.

Voluntary Madness is a brave book, written by a brave woman, and it addresses issues that just might leave you questioning your own sanity. The SunPost caught the courageous crazy lady on the eve of her nationwide book tour and gave her the third degree. Here’s what she gave back:

Are you crazy?

(Laughs) That’s a very good question. That’s a big part of the point and I think that if I went to a hundred psychiatrists, I’d probably get a hundred different answers and no criteria by which to judge.

Some might argue that checking oneself into a loony bin itself suggests a certain insanity.

Yeah, it’s funny. And I learned the hard way that probably wasn’t the wisest course. Now I know that’s probably the last thing you want to do, whether you’re well or ill, unless you absolutely have to.

Were you concerned about potentially detrimental effects on your health?

Definitely. Granted, I knew I was probably only going to be in each place from 10 days to two weeks so I figured it would probably be minimal exposure, but I really did do a lot of things like practicing yoga, watching what I was eating, and trying to do whatever I could to keep the dark forces of the institution at bay. So yeah, that was a big worry, and it was one of the reasons why it was hard for me to do this project.

What about the stigma attached to institutionalization?

Actually, I really dove into that one. I think that was one of the other reasons why I decided to write the book. I’m one of those people who just says a lot of inappropriate things, because I’m kind of interested in what’s considered inappropriate, you know, you see the line and then you step over it to see what happens, and I think that was it. I realize a lot of people are uncomfortable [with the subject:]; they don’t really want to know. Even if you’re pretty comfortable talking about it, they get squeamish. And that’s the stuff that interests me, what makes people squeamish, and wanting to talk about things other people don’t want to talk about.

Are the people in the bins really crazy?

Some of them, definitely, there’s no question. Again it’s hard to define what you mean by that. Are they disturbed, out of touch with reality? Sure. Then there are a whole host of other people like me, which was really my concern, who are borderline. I’m not out of touch with reality. As I say, there are challenges. I met people who are depressed for what I thought were pretty good reasons. But yeah, there definitely were some clearly troubled people who probably at this point medication is one of the best things we have to offer them. But it’s not the only thing. And then there are a whole host of the rest of us who are probably over-diagnosed.

What were the primary maladies people were afflicted with?

Depending on where I was. In the inner city it was pretty much psychosis. My public hospital experience was people of color, indigent, psychotic. That was pretty much what I found there. And that’s why I chose a different location [for the subsequent treatment:], where I wanted a mostly white population. And it was where I found a lot of drug abuse and dependence, and a lot of depression, which you can probably understand why that might be the case. In those places, oddly enough, the psychotic people were much more high-functioning.

Would you recommend this remedy for others?

No. I would say absolutely avoid it unless you think that you are in imminent danger to yourself or to other people. I would say you’re much better off, especially given the cost, checking yourself into the Ritz-Carlton and having a nice week — get a private nurse, get a massage, eat well and get some exercise. I’m not saying that’s a cure-all for everyone, but I certainly found for me I would’ve been better off [staying in a hotel:] and having my family and friends around me.

You pretty much slam America’s whole health care system, do you think some sort of universal coverage might make things a little better?

I tell ya, this is going to be a very unpopular answer, but I think the only reason we ever deserve universal coverage or the only way we should get it is if we’re willing to participate. So say you’re over 50 pounds overweight, I don’t think you should be entitled to free health care. I think you need to partake in your own health. You just can’t go on living a really toxic lifestyle and expect the government to pick up your check. I think it’s the same with mental health. The prevailing opinion is it’s not your fault, here’s a pill. There’s a lot we can do to take care of ourselves. Yes, I think the system’s a total mess; I think it would get worse with universal health care. But I think a lot of the problem has to do with individuals needing to change their lifestyle.

So more of a self-reliance?

Yeah. I’m not saying the institutions don’t have a role to play; they do, and the government as well. But I’m a libertarian at heart so I’m always in favor of smaller government and privatization.

What is the best advice you’ve been given?

“There’s nothing wrong with you.” That was the best thing that anyone ever said to me. Which sounds kind of obvious in a way, and maybe it isn’t true, but I guess what she meant was, “You’ve been through a lot of things that were understandably pretty painful.” And I think this is true for a lot of people who are now being diagnosed as depressed, for example, or who have A.D.H.D. and all kinds of other pseudo illnesses. I think you have to understand that when you go through a divorce or you have a parent who dies or you’re working a job that you loathe every single day, those kinds of things wear on you. And I think the idea that somebody can take you by the shoulders and say “You know what, you’re having a normal reaction to a pretty awful thing” can be very healing and empowering. And you can say, you know what, I can change those things or I can take them into account and I don’t have to become — as I became — a psychotropic junkie.

If you could give your 20-year-old self one piece of advice — what would it be?

The last thing I say in the book: “If you want to be well, and you want to be happy, put your boots on.”

Are you familiar with Robert Whitaker’s Mad in America: Bad Science, Bad Medicine, and The Enduring Mistreatment of the Mentally Ill?

Yes! I can’t believe you [mentioned that.:] I read that as research for the book and I highly recommend it to anyone and everyone. I think it’s a very important book.

Did you read Susanna Kaysan’s Girl, Interrupted or Kesey’s Cuckoo’s Nest or Plath’s The Bell Jar, etc prior to writing the book?

Yeah, I did a bunch of research so I read pretty much all the mainstays of depression and institutionalization and all that stuff.

Do you see Voluntary Madness making it to the big screen? If so, who would you like to play you?

(Laughs) You know, I think it’s unlikely, but if it did terrific, I think it would be great, but God, that’s a tough one. It’d probably have to be guy because I don’t think there are any chicks who have enough chutzpah and who really look enough like an androgynous person to play me. I’d have to think about it.

Do you ever miss Ned?

As you can probably hear, Ned’s still alive and well. I’m talking to you like a guy right now. I don’t know if you noticed it, but I’m definitely giving you the guy thing. Ned’s still there. In some ways I wish I could get rid of him, but in other ways he’s very useful. I don’t ever miss being him, but I guess that I’m kind of glad that I managed to incorporate some of that guy-guy knowledge that kind of gets me through.

[Emily Kestrel · Rating 3 out of 5]

I stumbled across this book last weekend while browsing at a used book store, and while I had never heard of it or the author, it sounded right up my alley. I love mental health memoirs. Even more, I love mental health memoirs that are critical of our current pharmacological/institutional paradigm. And this book definitely had some good points, and was interesting enough to keep reading. Overall, I kind of wished I'd waited to get it through my library loan instead of buying it, though.

The author, Norah Vincent, describes how a flare-up of her long-term struggles with depression inspired her to exaggerate her symptoms as a mental health crisis in order to be admitted to three different psychiatric facilities in order to report on what it's like to be a mental patient from the inside, as it were. She chose three very different locations: an urban hospital serving a mostly urban poor/homeless population; a private mid-western clinic serving mostly middle class midwesterners; and an alternative, holistic clinic. She had bucket loads of opinions and a few interesting comments about each one.

To start with the good: Vincent is definitely a good descriptive writer. I could almost picture being with her at each of the facilities -- although in the case of the first one, most of the descriptions were pretty gross (deplorable eating habits and lots of bodily function mishaps). And she did have some interesting insights into what it's like to be a mental health patient.

The in between: the narrative seemed confused as to whether Vincent considered herself a journalistic spectator or a participant. I actually felt, as a reader, that she really was more of a participant but didn't want fully want to admit that to herself.

The bad: Norah Vincent is hella judgmental of just about everyone she runs across, staff and fellow patients alike. She assumes that nobody who is genuinely caring could possibly work at the inner city facility--obviously, Vincent has never worked in health care. She assumes most psychiatrists are arrogant shills for the pharmaceutical companies--despite describing genuinely caring and responsible shrinks that she meets in the course of this book. She really looks down on the support staff at these facilities--dismissing them as "slackers" who can't be bothered to find a more responsible job, naive young people who haven't had a bad life experience, or overweight "menopause mommies." These are just a few of the more egregiously dismissive comments that I can remember off the top of my head.

Worst of all is her long diatribe about depression being a failure of willpower or character--akin to the sins of sloth or gluttony--with depictions of her fellow patients as being overweight losers, weeping pathetically and wallowing in their misery. She honestly implied that depression was somehow taking the easy way out! Also, she denigrates those who chose to use antidepressants and other medications (although admits to using them herself). I think that this, more than anything, is what's problematic about the book, and why I couldn't rate it higher than three stars. As someone who has struggled for most of my life with depression and anxiety--always while working full time, trying to be decent and caring to everyone around me, and never wallowing or using my problems as an excuse--I found those comments actually offensive. And I almost never get offended over books! Norah Vincent might suffer from depression, but she doesn't understand it. Which makes her book, ultimately, a rather pointless exercise.

Final impression: there's some good content here, but overall I felt the author was trying too hard to be "too cool for school." And all the interesting insights in the world cannot make up for her complete lack of compassion.

[Julia · Rating 1 out of 5]

Okay, I think I made it 80% of the way before I just couldn't do it anymore. I tried.

In Voluntary Madness, Norah Vincent looks at the differences in psychiatry and therapy by admitting herself to three different mental health facilities. Unsurprisingly, she finds the approaches in care are vast and the treatment costs all exorbitant. The topic is worthy of exploration but the author's delivery is awful. Simply put, Norah Vincent is a pompous navel-gazer. The other patients she encounters are really made out to be characters: goofy, weird, overly dramatic, unnecessarily medicated. That's a big point of contention with her--the over prescribing of medication by doctors she largely finds to be idiots. If she offered some meaningful insight into experiences, offered some valuable solutions, or displayed some real kindness to anyone other than herself, maybe this would have been a fine book.

[Jamie Bronstein · Rating 2 out of 5]

Oy.

I'm glad I don't personally know Norah Vincent because she seems like the world's most annoying person. I started this book thinking it was going to offer some insight into the workings of the mental health system, a sort of Nelly-Bly thing, if you will. Instead, I had to plow through almost 300 pages of whining by a person who seems fundamentally uninteresting.

She got herself admitted to, serially, a large public hospital, a rural private hospital, and then a third thing called Mobius that combined therapy with homelike living and some martial arts. In describing her experiences, she alternated between navel gazing in a very shallow way (the reader knows almost nothing about her life, her preferences, her relationships), and cutting down the other people who were institutionalized at the same time. And her recommendation was for people to eschew psychiatric meds and pull themselves up by their bootstraps. Not only does this not work for anyone, it didn't even work for her.

[Tina · Rating 2 out of 5]

I read this book thinking it sounded interesting because immersion journalism usually is, and even if it wasn't completely that, books about "crazy people" are right up my alley.

Wrong on both counts. I finished it because it's a short read. There were several things about this book that bothered me.

First of all, there are the constant diatribes against psychotropic medication. They would have been perfectly valid if she had included ANY evidence whatsoever to back up her claims - a reference to an article in a medical journal, a news article, a damn google search, SOMETHING that would have validated her point. Instead, you have to take her claims at face value, and they fly in the face of her willingness to take them when she feels the need. Clearly, she thinks they work, even if she only believes that grudgingly.

Second, her descriptions of Meriwether and the patients/staff there reek of arrogance and (dare I say it) entitlement. In the interest of full disclosure, I have "done time" in a public hospital psych ward, and I found that entire part of the book completely insulting. Everyone on the ward is described as behaving disgustingly and psychotic (with the exception of the nice white woman with whom she felt a kinship), except for the staff who lacked any sense of "humanity" and the doctors whose only purpose was to prescribe meds.

This bugs me because it doesn't take a genius to figure out the societal causes that led to these people being locked up in this hospital in the first place. And after she's let out, with the locked door to the ward behind her, she starts making generalizations about the plight of the patients in a place like that. My personal favorite was, "The psychotic people I knew and lived with were more confused and disoriented than anything else." I find it really hard to believe that she was able to get any kind of grasp as to what was going on in these people's lives. In a situation like that, everyone talks about how they got admitted and why, but no one talks about what their real issues are, psychosis or no. And please don't get me started on her ranting about the crappy food being fed to them, and her complaints about patients not being able to have a smoke break.

Third, when she checks into St. Luke's, she is obviously depressed and the book changes its tone. She sneaks into an AA meeting because they're more hopeful than any of the groups over in her part of the hospital, where those with mental illness (namely depression) are kept. And she starts to get sick of the whining from the other depressed patients. Here's where her philosophical ideas about depression being a form of gluttony and sloth kick in, and you are left wondering if she thinks mental illness is your own damn fault. She also makes an argument for ignorance as a way to keep yourself from going into a depressive stupor.

The last place she visits is a place referred to as "Mobius" which, judging from the descriptions she gave, is a clinic with a more holistic approach to mental health that gives you a lot of freedom. Meds are optional, therapists are available if you need to talk, and they are constantly having you do activities like den chi bon (sounded like a form of rock and roll yoga) and building sand mandalas.

Here is where she finds the most help, she says, though the same probably could have come from a vacation. But it's here that she seems to fully acknowledge the enormity of her underlying issues, and that she's going to have to work to stay mentally healthy by going to the gym, eating healthy, being aware of her feelings, and knowing how to self soothe. And this, upon reflection, is my biggest problem with the book.

I have never had a psychiatrist/psychologist tell me otherwise.

She makes sweeping generalizations about psychiatrists that make me wonder how many she has had. I've had 4-5, and some were cold (but I never had a problem with the meds they prescribed), some were warm and welcoming (but prescribed meds that often made me worse). I'm not going to judge the whole profession based on them because ultimately it is a painfully small sample. Some people are better at their jobs than others. Who knew.

Guess what? With doctors - any kind of doctors - it is ALWAYS hit or miss. With mental health doctors/therapists/hospitals, even more so. So much of the benefit of therapy simply comes from having a good relationship with your therapist. And part of staying healthy is taking care of your body - the cognitive benefits of physical activity are well documented and you'd be hard pressed to find a doctor who believes that a pill is the be-all end-all.

Her view of the issues is narrow - seen through the gaze of someone who has had the privileges of education and economic security. I'm glad she got the help she needed for the problems she had, but if she's going to write about "madhouses" as a journalist, then her focus should be there. Her conclusions were more philosophical than concrete, and more about the personal nature of mental illness/health than the social issues constructed around how we deal with it as a culture - a hugely missed opportunity in my opinion. It could have read as an indictment of our mental health system - instead, it's more about personal discovery.

My point is this - skip it.

[Jess Wood · Rating 1 out of 5]

Only finished because it gave me an excuse to feel furious/disgusted/outraged for a little longer.