Nobody's Normal: How Culture Created the Stigma of Mental Illness

by Roy Richard Grinker

For centuries, scientists and society cast moral judgments on anyone deemed mentally ill, confining many to asylums. In Nobody’s Normal, anthropologist Roy Richard Grinker chronicles the progress and setbacks in the struggle against mental-illness stigma—from the eighteenth century, through America’s major wars, and into today’s high-tech economy.

Grinker infuses the book with the personal history of his family’s four generations of involvement in psychiatry, including his grandfather’s analysis with Sigmund Freud, his own daughter’s experience with autism, and culminating in his research on neurodiversity. Drawing on cutting-edge science, historical archives, and cross-cultural research in Africa and Asia, Nobody’s Normal explains how we are transforming mental illness and offers a path to end the shadow of stigma. The preeminent historian of medicine, Sander Gilman, calls Nobody’s Normal “the most important work on stigma in more than half a century.”

Genres: Psychology, Nonfiction, Mental Health, History, Science, Self Help, Health

448 pages, Hardcover

First published January 26, 2021

About the author

B. 1961

Professor of Anthropology, International Affairs, and Human Sciences at The George Washington University.

Grinker is an authority on North and South Korean relations. As part of his PhD research, he spent two years living with the Lese farmers and the Efé pygmies in the northeastern Democratic Republic of the Congo as a Fulbright scholar. He has also conducted epidemiological research on autism in Korea.

Reviews

[Morgan Blackledge · Rating 5 out of 5]

I honestly can’t get over how mind expanding this book was for me.

It’s at the very top of my list this year.

Nobodies Normal is anthropologist Richard Grinker‘s multi pronged historical deconstruction of stigma and normativity related to mental health.

Grinker asserts that the word normal is essentially a statistical term of art, and technically refers to segments of populations, not to specific qualities of individual bodies and behaviors.

Normal was only applied in its current popular usage e.g. as a standard for individual human form and functionality in the mid 20th century.

Normal is a very western construct. Which is not to say other cultures don’t stigmatize aspects of human presentation. They definitely do. Just not in the same ‘statistically derived’ way.

Grinker, also discusses how the forces of capitalism have shaped constructs of normalcy and stigma regarding mental health.

Grinker posits that, as western economies transitioned from agrarian to industrial, an individual’s ability (or inability) to participate in the labor force was the important dividing line between being ‘normal’ and defective.

Think Britny Spears.

As long as she can get her shit together and do her ‘Pieces of Me’ show. She’s fine. But when her “mental health issues“ interfere with her ability to perform (think 2007 VMA’s) well then we have to get conservatorship.

This is not to say that she doesn’t have very real mental health issues, only that the normative standard is very linked to her ability to work.

In a different time, and in a different place, and under different socioeconomic circumstances, our standards and tolerances for Britney’s behavior would certainly be very different.

A seemingly obvious but important point nonetheless.

#LeaveBritnyAlone!

Grinker also discusses the influence of war on mental health diagnosis and treatment.

Grinker posits that WWI, WWII, Viet Nam, and the Gulf Wars have all left their mark on mental Heath care.

Specifically in regard to disorders involving traumatic exposure. Again, the soldiers ability to continue in the fight, and their potential burden to the VA have been major influences on the way we currently conceptualize, evaluate, diagnosis and treat trauma.

I say currently, because essentially all of our conceptualizations, psychometrics, diagnostics and treatments have changed dramatically over time, largely based on economics, culture and current events, and are inevitably going to continue to do so in the future.

This is not necessarily a good or bad thing.

But simply the way it is.

Some of the more profound points Grinker makes emerge from comparisons of different cultures attitudes, standards and and tolerances regarding mental health and neuro-diversity.

There’s far too much interesting shit in this book to discuss in this venue.

Suffice it to say.

Nobodies Normal is WAY fucking good!

There were issues covered in this text that caught me utterly flat footed. Ideas, observations and perspectives that I have simply never considered.

In the end, I’m emerging from this text with many banal assumptions challenged, with far les fixed and rigid ideas about mental health, and with a significantly enhanced understanding of the powerful role culture plays in psychology and psychiatry.

In the tradition of Eric Fromm, Michele Foucault and Derald Wing Sue, this is psychological anthropology at it’s very best.

If you think you don’t need this in your life.

You’re wrong.

[Chris Boutté · Rating 5 out of 5]

I'm a recovering drug addict with over 8 years sober, and one of the reasons I self-medicated with substances was due to the stigma around mental illness. Since getting clean, I've become an advocate for mental health, and decreasing the stigma is one of my main goals. So, when I heard this book was coming out, I had to grab a copy. This book from Richard Grinker has a great, thorough history of how we treat the mentally ill around the world and what the stigma does to people. He even dives into the mistreatment of those with disabilities or those who are neurodiverse, which makes the book even more well-rounded. 

Although this is an incredible book that I really think more people can read, the structure of the book felt a little off and seemed to drag a bit. For example, in the first half of the book, Grinker spends a few chapters talking about mental illness in the military, which is extremely important for understanding the history, but it really slowed the book down. Maybe it's because I'm already familiar with the subject, so that may just be my opinion. Regardless, this is an excellent book that I really hope gets the attention it deserves.

[Ashley Peterson · Rating 3 out of 5]

Nobody’s Normal: How Culture Created the Stigma of Mental Illness is written by Roy Richard Grinker, an anthropology professor at The George Washington University. Autism and cross-cultural psychiatry are listed as areas of expertise on his faculty page. He’s the father of an autistic daughter, who he refers to a number of times throughout the book.

Culture
The book revolves around the idea that mental illness is a product of culture and capitalism.

The first section of the book looks back through history, painting an oddly rosy picture of life for crazy folk back in the day. I spent much of this section being annoyed with what I was reading.

There’s mention of a 15th century “asylum for the ‘insane'” in present-day Morocco, with the odd juxtaposition of them being frequently bound and whipped but also them being surround by fragrant plants and having reassuring conversations with doctors, as if the latter made the former just fine and dandy. Any takers on the whipping?

The author says that in the early 1800s in western Europe, many ill people were kept in chains by their family members, but not because they had something their family members called “mental illness.” To me, that seems like saying people are having legs amputated because of gangrene, but they didn’t have something people recognized as being a thing called gangrene. Whether it’s crazy or rotting foot, not having a medical term to frame it in doesn’t make it less undesirable.

The book opens with a story of someone from the Jun/oansi, a hunger-gatherer people in the Kalahari Desert in Namibia. Someone has schizophrenia-like symptoms, but it’s not seen as “mental illness”; it’s spirits sent by other people, and not the ill person’s fault, so it’s all just wonderful. That’s a nice thought, but the possession by spirits belief doesn’t necessarily translate into positive treatment. It can translate into people being chained to trees for years out of desperation because their family can’t manage them any other way.

Speaking of which, Grinker criticizes a paper published in Nature with a photo showing a Somali girl chained to a tree. He argues that this “conceals the content of her life”, including family, politics, and religion. Yes, there’s content and context that’s not shown, but to suggest that the context is sufficiently enriching to make up for the poor kid being chained to a tree seems unnecessarily Kumbaya.

The author later points out the problem of taking a Western approach to illness in non-Western countries, but, in my mind, he missed the mark with it. Psychosocial interventions like prayer can only do so much, and it doesn’t help the people with mental illness if we encourage more praying and then wash our hands of it all. Culturally appropriate and effective should be able to co-exist.

Family ties
The author’s grandfather and great-grandfather both make repeated appearances in the book. His great-grandfather, who migrated from Prussia to the U.S., became a neurologist. He attributed insanity to an inability to control impulses, especially the desire to shop.

His grandfather did psychoanalysis with Freud as part of his psychiatric training, and in World War II used sodium pentothal (“truth serum”) to help soldiers access their trauma. The book also covers how mental conditions were viewed in WWI, the Korean War, Vietnam, Afghanistan, and Iraq, and how little seemed to be learned from one war to the next about how trauma affects people.

Medicalization
The author described medicalization as an integral component of capitalism, and called the “broken-brain model” an attempt to “give mental illnesses an objective reality apart from culture.” He gave electroconvulsive therapy (ECT) as an example of the problem with the broken-brain model; despite its high level of efficacy, it’s highly stigmatized because it’s rooted in that broken-brain model.

He also discussed how medicalization relates to autism and the anti-vax arguments, as well as chronic fatigue syndrome. He argues that the biological model of CFS/ME is problematic because it gets in the way of psychological interventions that could potentially be helpful. There’s a valid point in there somewhere, but you may find yourself annoyed before he gets to it.

Among the assorted points that I disagree with was Grinker’s argument that it’s actually a good thing that people are saying things like “a little OCD” or “a little bipolar,” as it validates that mental illnesses exist on a spectrum rather than being all or none, and decreases the stigma of those labels. I’m imagining some of my readers being rather unimpressed as they read this.

The author isn’t so keen on the whole brain business, as “neuroscientific approaches to understanding and treating mental illnesses perpetuate stigma by reducing the complexity of illness experience, or our personalities, to the brain.” He then adds that he’s not suggesting that neuroscience can’t come up with new treatments, but it can’t reduce stigma.

Sigh. This was one of many points in the book where there was a valid idea packaged up in a less than palatable way. For the first third of the book, I thought I disagreed with the author entirely, and it was only in the final third that I started to realize what he was actually getting at, and discovered I didn’t disagree with him as much as I thought.

Presenting mental illness to the public as a brain disease is associated with increased stigma; that’s what the research on the matter clearly shows. However, Grinker seems to be implying that biology needs to be tossed out the window. I don’t think that’s actually where he’s trying to go, but he’s pointing a sign in that direction, perhaps inadvertently.

My own theoretical perspective regarding culture tends to be along the more moderate lines of social constructionism; basically, the way we experience reality is socially constructed, and can never be fully separated from the social context. That’s not to say that mental illness doesn’t exist on an objective level, but the meanings attached to it and the way it’s interpreted are inextricably culture-bound. What Grinker was saying probably wasn’t too far off from where I stand, but with less of a space for mental illness on a realist level. Still, I found he was setting off my “this jerk doesn’t think mental illness is real” BS detector fairly regularly. I do think that’s more how he framed things than the essence of his ideas, but it was still there.

The book concluded with Grinker saying he wants readers to take away that stigma can be a conversation starter, not ender. Now that, at least, is a message I can whole-heartedly agree with.



I received a reviewer copy from the publisher through Netgalley.

[Cav · Rating 2 out of 5]

"We are acknowledging that mental illnesses are more common than we used to think, and that they affect us all—either individually or because of our relationships to others..."

Despite being excited to start Nobody's Normal, it ultimately did not meet my expectations. For a book about psychology and psychiatry, it managed to include an absolutely baffling amount of superfluous partisan political commentary. More on this below.

Author Roy Richard Grinker is an American writer and Professor of Anthropology, International Affairs, and Human Sciences at The George Washington University.

Roy Richard Grinker:


The author continues the quote from the start of the book:

"...Indeed, it is impossible to imagine that there is anyone unconnected to mental illness. In the twenty-first century, many of the people we most admire—celebrities like Lady Gaga and swimmer Michael Phelps, for example—speak publicly about their own emotional struggles. Also, in comparison to their parents, millennials are more willing to disclose a diagnosis and seek treatment. Many people, like my daughter Isabel, who is autistic, even celebrates forms of differences that just a few decades ago were a mark of shame."

The book opens with a decent intro. There is a long discussion about the meaning and definition of stigma(s); what they are, and where they came from. This proved to be a harbinger of the writing to follow, which I found to be a bit long-winded and dry for my tastes more often than not.

The formatting of the book also left a bit to be desired for me, as he revisits the same subjects across many different chapters. The book is seriously lacking narrative continuity and overall flow. I generally don't like books formatted in this manner.

The author lays out the scope of the book in this quote:

"This book chronicles the many cultural and historical threads that have brought us to the present, a time when societies throughout the world are challenging the stigma that has, for centuries, shadowed mental illnesses.
We haven’t put it into words, but most of the people I encounter, even in low-income countries with inadequate health care, sense that something positive is happening. Although 60 percent of people with a mental illness in the United States still receive no mental health treatment,1 mental illness is fast becoming a more accepted and visible part of the human condition."

And talks about the severity of the problem in this bit of writing:

"In any given year, nearly 20 percent of American adults—more than 60 million people—meet the criteria for a mental illness.2 Many of these conditions are mild, short-term, and self-limiting. But others have serious consequences. Anorexia nervosa, perhaps the most fatal of all, has a mortality rate of as high as 10 percent, by some measures.3 Suicide, almost always associated with mental illnesses, is the third leading cause of death among American teenagers, and most who die never received any mental health care. In 2013, a Centers for Disease Control and Prevention (CDC) survey of American high school students nationwide showed that more than 13 percent said they had at some time in their lives created a plan to commit suicide, and 17 percent “seriously considered suicide.”4 But many felt too ashamed to tell anyone in their family. Every year, mental illnesses account for at least 12 percent of the total disease burden worldwide, and many people with serious mental illnesses and intellectual disabilities in lowincome countries like South Sudan, Somalia, and Uganda are condemned to a life of confinement and abuse in their villages.5"

Some more of what is covered in here includes:
• Masturbation; John Kellogg and the invention of Corn flakes
• "Shell shock"
• "Hysteria"
• Freudian psychoanalysis
• War
• Homosexuality
• Communist brainwashing (oh, the irony)
• Post-traumatic stress disorder (PTSD)
• Psychogenic disorders
• First-generation antipsychotics; Thorazine
• Anorexia nervosa
• Schizophrenia
• Autism
• Phenylketonuria (PKU)
• Electroconvulsive therapy (ECT). Some interesting writing here
• "Penis theft"; psychosomatic disorders

Unfortunately, despite a rather innocuous intro, the book proper contains a virtual torrent of assorted leftist political ranting. In fact, it sounds like the author views the problematic history of the field of psychology mostly through a Marxist critical theorist lens. That is; it was a branch of science mostly devoted to subjecting the lesser races, women, and homosexuals - all by the evil white man (of course).

My jaw just about hit the floor when the author drops a quote by Karl Marx at the beginning of one of the chapters. He writes critically of capitalism and speaks fondly of socialism many times throughout the book. Ok, comrade...

Missing from this low-resolution take is the fact that many people of all stripes were subjected to terrible treatment at the hands of early medical practitioners of this pioneering field of study; not just black Africans, gays, and women. Indeed, if you've done any reading about the history of modern medicine, you will know that it was often pretty gruesome, no matter where you sat on the victimology hierarchy.

Thankfully, this was mostly concentrated in the first ~half of the book; although bits of partisan jargon appear throughout. The latter part of the book fortunately contains some interesting writing about autism as well as ECT that I have not read elsewhere.

To be honest, all this partisan preaching in a book about science is so fucking tiresome. A large reason I read so much about science is to get away from the culture war and politics. That the author felt the need to add so much partisan rhetoric and commentary leads me to believe he is ideologically possessed, and just can't help himself. Which is pretty ironic, considering that this is a book about psychology and social psychology...
"People don't have ideas. Ideas have people," after all.

He closes the book with this quote; cramming in about as much leftist nonsense into a paragraph as possible:

"...When someone is homeless, our first thought is that the person has failed as an individual rather than to question the historical legacies of discrimination and inequality. When a person does not fit a preexisting or assigned sex or gender, our first thought is that the person has a mental or physical disease rather than to question our definitions of normality."

***********************

I have no doubt that many will find value in this book, but the author's repeated leftist political evangelizing really put me off.
There are many other books that deal with the troublesome history and dysfunctionalities of the field of psychiatry in a much more detailed, balanced, and nuanced fashion than this one, that leave the politics at the door.
I can recommend Mind Fixers: Psychiatry's Troubled Search for the Biology of Mental Illness, Cracked: The Unhappy Truth about Psychiatry, and Desperate Remedies: Psychiatry’s Turbulent Quest to Cure Mental Illness.
1.5 stars.

[Cecilia Cicone · Rating 5 out of 5]

This book was amazing and I am so grateful it exists. From detailing how capitalism and our sense of the importance of productivity has stigmatized mental illness to encouraging openness and suggesting how to be honest and adaptable with these struggles, I have so much to think and pray about.

[Dramatika · Rating 4 out of 5]

You might have noticed that despite the many claims of the author the stigma of mental illness became less and less prevalent today. Moreover, seemingly ordinary behavior that was thought just typical stages of every day life, like irritability, anger, or mood things suddenly could be explained by not being ordinary life human being but by a number of (always ready at hand) psych disorders straight out of the DSM-5. There was even a certain honor of not dealing or improving one's own behavior, as this is beyond control of the individual who is alas can't help but be his sick psych self. Nevertheless, there are certain behaviors more readily suitable for fashionable psych disorders than others. Bipolar is in, psychosis and all kind of chemical addictions definitely out! This is no to belittle any real sufferings of the people with such disorders, but I know many perfectly stable people with good jobs, families and active social life who claim to be bipolar all of a sudden. Clearly many don't realize the true severity of this disease. I remember the time when borderline personality was all the rage, another very serious and very disabling disorder. There is fashion for mental disorders too!
On the other hand, many people suffering from the complications of horrible Covid 19, for instance, emphasize the neuro biological component of their psych symptoms as if to suddenly succumb to normal PTSD of the real psychotic episode we all live through right now is to show weakness. I believe both biological and actual collective psychosis factors are at play here.
The book is heavily emphasized on psychoanalytic approach as the author's father and grandfather specialized in psychoanalysis. It is the one view through which lenses we look at different descriptions of mental health in different cultures. And yet we come back to the definition of normal in all its varieties. It might be a spectrum and the less clear boundaries, but time and again throughout the book we still can't completely ignore the marks on this continuum specifying the boundaries of normal definition. We might change the language and use neurotypical and neurodiverse but still define the scale and it measures. One thing that the author didn't emphasize enough is the enormous burden many people with mental health disorders place on their families. With the reduced funding for mental health facilities many dangerous to themselves and others are left at home to be cared by their strained families. Schizophrenia is a very prevalent disorder that many people are treating successfully but still require hospitalization from time to time. With the approach of less stigmatization and normalization of mental illness sometimes result in disastrous consequences for the mental health facilities so desperately needed by the people in urgent situations. In other words, the actual stigma for mental health issues exist, yet it doesn't mean that the mental health diseases are not real, however one might define them. I think that the disease manifestations are cultural and yet even that is changing due to globalization. ADD wasn't diagnosed when I was growing up, yet most of the kids somehow made it though school despite the horrors of the rigid education system. What worries me now is medicalization of the previously normal human experiences of grief and suffering and yes sadness. I refuse to be positive and cheerful all day long. I'm gloomy and pessimistic and find life truly miserable and its everyday struggles. Yet this is real me without the support of medication. The fakeness of all American smile is what many Europeans notice the most (I bet ppl in US disagree). This false cheerfulness must be observed at all times, with the help of medication if necessary. I wonder what the author thinks of that.

[Edward Sullivan · Rating 4 out of 5]

An interesting, insightful chronicle of how mental illness became stigmatized and examination of how attitudes are gradually evolving. Grinker writes compassionately about the subject and infuses the narrative with the personal history of his family’s four generations of involvement in psychiatry.

[Rennie · Rating 3 out of 5]

Interesting and mostly very readable history of psychiatry. My interest did flag a bit eventually though. But the last chapter or so covering some of the progress that’s been made very recently in being more understanding and accommodating of people with neurodiversities, like even in major corporations’ hiring practices (and Berlin brothels!) was great. The looks at how mental illnesses manifest and are interpreted in different cultures was a highlight throughout.

[Buck Wilde · Rating 1 out of 5]

Stigma BALLS!

An uninspired utopian screed that shames the families of the mentally ill for not facilitating them a Peter Pan suspended animation of eternal childhood, then follows each paragraph of tsking with "but such a thing is impossible, because the workers do not control the means of production."

Yes, you heard that right. A lifer academic positing that capitalism is the root of all evil. How novel. In his defense, they start pounding that into you during freshman gen eds, which means Grinker's been absorbing these constant bombardments of Marxism since 1979.

It was also a sort of memoir he uses to malign the long line of psychiatrists from which he descended. He explained the ways in which they behaved unwokely, and how this was bad, and he would not behave in such a way, you see, for he is good.

I tapped out about a third of the way through the book. If I wanted to hear some maudlin, virtue-signaling perpetual collegiate with a victim mentality decry their family as toxic and beg for other people's money, I could just go on Facebook.

[Maher Razouk · Rating 5 out of 5]

جاء البريطانيون إلى جزيرة مارثا فينيارد لأول مرة في أوائل القرن السابع عشر ، عندما كان لا يزال يقطنها مجتمع محلي من عدة آلاف من هنود وامبانواغ. كما هو الحال في المستعمرات ككل ، تضاءل عدد الهنود هناك بسرعة ، بينما زاد عدد السكان البريطانيين. على مدى أجيال ، تزوج المستوطنون بعضهم البعض ونادرًا ما سافروا حتى إلى جزيرة نانتوكيت المجاورة ، على بعد ثمانية وثلاثين ميلاً فقط . بحلول منتصف القرن الثامن عشر ، كان هناك ثلاثون لقبًا مختلفًا فقط بين 3100 مقيم بريطاني ، وبدأت عواقب زواج الأقارب بالظهور.

في هذا التجمع الجيني المغلق ، ظهر اضطراب وراثي. بحلول نهاية القرن التاسع عشر ، كان ما يقرب من ربع السكان يعانون من درجة ما من الصمم الوراثي. لكن الصم والصم جزئيًا والقادرين على السمع ابتكروا لغة الإشارة الخاصة بهم حتى يتمكنوا من التواصل ، ويفترض سكان الجزر - الذين لا يوجد سكان آخرون لمقارنتهم بهم - أن الصمم كان مجرد جزء من الاختلاف البشري. في الواقع ، كان الصمم شائعًا لدرجة أنه في الروايات الشفوية التي تم جمعها في القرن العشرين ، واجه أحفاد المستوطنين صعوبة في تذكر من كان من بين أصدقائهم وعائلاتهم أصم أو يسمع. قال أحد كبا�� السن في عام 1980 : "كما ترى" ، "الجميع هنا يتحدثون لغة الإشارة".

بمرور الوقت ، عندما غادر الناس مارثا فينيارد ، ووصل سكان جدد ، اختفى الصمم الوراثي . لكن السكان المحليين كانوا مازالوا يتذكرون لغة الإشارة ، واستمر الكثير من الأشخاص الذين يسمعون في استخدامها مع أشخاص آخرين يسمعون . بعد سنوات من آخر ساكن في الجزيرة مصاب بالصمم الوراثي في عام 1952 ، على عكس المناطق الأخرى ، لم يتم تمييز الصم ، لأن الجميع يتحدثون بلغة الإشارة ، وبالتالي ، فإن الصمم ليس إعاقة ولم يتم وصم الصم بالعار. ونظرًا لأنه لم يتم تمييزهم كمجموعة ، فإن الأشخاص الذين لا يستطيعون السمع لم ي��م تصنيفهم أبدًا على أنهم "صُم".

كان جمال اختراع لغة الإشارة هو أن سكان الجزر طوروا تكيفًا ثقافيًا مع الإعاقة السمعية. إن ذلك يقدم أحد أفضل الأمثلة على كيفية إنتاج الثقافة ، وليس الطبيعة ، وتحديد ما يعتبر طبيعيًا وغير طبيعي. كانت الثقافة - العزلة الاجتماعية والتزاوج المختلط - هي التي أوجدت المشكلة البيولوجية ، ولكن بعد ذلك كانت الثقافة قوية بما يكفي ومبدعة بما يكفي لتجاوزها. نظرًا لأن الأشخاص الذين لا يسمعون كانوا مندمجين تمامًا في مجتمعاتهم وكانوا قادرين على التواصل مع الجميع ، يمكننا حتى القول إنه لا يوجد أحد "أصم" حقًا في مارثا فينيارد.
.
Roy Grinker
Nobody's Normal
Translated By #Maher_Razouk

[Jessica J. · Rating 2 out of 5]

Mental health stigma is a topic that I am very much interested in, and I think Grinker makes a lot of good points about how the capitalist emphasis on comformity leads to stigma, but his writing is clunky, often contradicting itself and not making a clear point. There are also several statements where I'm outright questioning his assertion of a fact:

"By the early 1800s, according to historians, 'in moral discourse there was hardly any overlap between the active resolute male and the emotional, nurturing, malleable female. Woman was constructed as 'other' in a more absolute sense than ever before.'"

Did he forget about the Salem Witch trials? No, he acknowledged that they happened and that women were unfairly targeted on the basis of their womanhood, but he also repeatedly states that 'otherness' was not stigmatized, at leas in Western culture, before the Industrial Age. Is he not he aware that women couldn't hold property in colonial America, nor could they vote? Women were 'othered' well before the 1800s, Roy.

[Shane]

I got about 25-30% into this and realized I was dragging my feet. Too much war history and details about his grandfather meeting Freud. I think I wanted a more succinct overview and fewer details about gruesome treatments as well

[Christine · Rating 2 out of 5]

2.5 Stars rounded down

It wasn’t bad and had some good points/perspectives, but it was ruined for me because the author is conducting research that’s funded by Autism Speaks, and his general writing about autism also felt a bit old-fashioned.

[Steven · Rating 3 out of 5]

This book covers a lot of ground, but throughout, Grinker gives examples -- some quite personal -- of how culture defines mental illness and how society approaches it. A less constant thread, but one that pops up here and there, is capitalism's role in defining mental illness. He writes that a lot of our thinking around mental illness centers around patients' "worth" -- what they "contribute" to society, or conversely, how much they and their illness "cost."

One of the best examples comes early in the book in the discussion of a mentally ill tribal member in Namibia. When he goes into town and seeks treatment and medication, he's labeled and treated as schizophrenic. But when he's in his community, his troubles are considered to be caused by malevolent spirits - it's not his fault, and his community supports and cares for him.

There's a lot going on this book -- the evolution of the DSM, medication vs. talk therapy, electroconvulsive therapy, institutionalization vs. community integration. But ultimately, it's about our attitudes to mental health -- how they've changed over time, and how we can do better.

This author also has an interesting background, descending from three generations of neurologists and psychiatrists, including a grandfather who was analyzed by Freud. He is also the father of an autistic child.

[Mel · Rating 5 out of 5]

Really enjoyed this one. It was like a step up from No One Cares About Crazy People (Ron Powers) and covered more ground than schizophrenia. I found it to be rather validating in that over time “normal” evolved and we’re at a point now where we can just throw the whole word out because it allows us to easily condescend and discriminate against people who are different from us. And yet, our differences is what makes us good. I’m not normal and I don’t want you to be, I want to simply be me and for you to be you.

[Lorisha A · Rating 2 out of 5]

Filled with information I was already familiar with. I was craving some new theories when I picked it up.

[erebus K Rushworth · Rating 5 out of 5]

I picked up this book because I was recommended it through book club. I grappled with attempting to read it with my eyes for months... but eventually ripped through the last half of the book by listening to the audiobook. It certainly reminded me of a lot of my own personal discoveries, and experiences growing up as a confused Autistic child, and with the knock on psychological effects of being a social misfit.

I'm probably not the target audience because much of this is not new to me. This is a highly comprehensive look at the history of modern psychiatric and cultural ideas about mental illness. It's quite centred on the Global North, as this is where the science of psychiatry is used and developed, but there is also some anecdotal insight into the ideas and practices of traditions from many different parts of the world. If you did an anthropological deep dive into the concepts of mind from people of all continents you could probably fill 15 of these books.

Major foci of this book include what are called (in modern terms), Depression, Anxiety, Psychosis, PTSD, Schizophrenia, ADHD and Autism. Accounts are thoughtful and not minimizing. A section of the book is dedicated to unpicking some myths about Electro-Convulsive Therapy (ECT), and the lingering, demonizing influence of movies like the film adaptation of One Flew Over the Cuckoo's Nest on the minds of several generations. The stereotyping of Autism in media is also mentioned.

If you are unfamiliar with this stuff it's a really good jumping off point. The narrative is accessible without too many confusing terms, and the tone is mostly serious without being too dry.

[Rachel Pollock · Rating 4 out of 5]

fascinating and illuminating

An excellent book on stigma and the development of mental health diagnoses and treatments, and a perspective shifting read. Highly recommend!

[Stella Hansen · Rating 1 out of 5]

Horrendous. Another long review incoming

[Marsha Dommel · Rating 3 out of 5]

I found really great, thoughtful and well researched aspects in this book. However, the entire premise was to work on dispelling stigma and awareness of terms used. In this vein, the author failed by constantly stating 'committing suicide.' This is a very antiquated term of those who attempt or die by suicide. It is vital to not criminalize this act and my career is based on such.
I think there are outstanding points, but did also find myself wanting more from this book. I vacillate between rating this book as a 2 or a 3 but ultimately think there is a lot worth learning as well created a dialogue for me.

[Siskiyou-Suzy · Rating 2 out of 5]

Just finished.

I don't think this book is great; it is okay. I think the author set out to do something really big and just couldn't quite do it.

There were good pieces but there wasn't an overarching passionate argument being made. I mean, we get that stigma is maybe not great but it's just not the information packed, excited book that I so cherish reading.

And I'm put off by his insistence on this argument that women used to be a lesser version of men and not viewed as seperate. I don't think he justified that argument to the extent he took it.

And yeah, more about war than I care about.

[JH · Rating 4 out of 5]

An interesting book that covers a lot of history I was fortunate enough to learn in residency. The cultural perspective had some new information and the stories about the doctors in Nepal really made his points clear. I’m not sure he fully brought his premise home in the end but I found the book interesting and well researched.

[Spencer Long · Rating 4 out of 5]

I have read books about mental health, but this was the first one that analyzed the subject in relation to cultural contexts. For example, I found it incredibly fascinating how the advent of capitalism led to an increase in the stigma related to mental illnesses. Western culture has a very limited idea of what being useful to society is, so when people with disabilities can’t work a mainstream job independently, they can feel useless. Capitalism praises efficient employees and puts bootstrap entrepreneurs on pedestals, so that people who don't fit into this capitalistic box of productivity, are stigmatized. Grinker shows that our relationship with mental illnesses is dependent on the culture we are surrounded by. For example, in Namibia, many people believe those with mental issues are in fact possessed by evil spirits sent by other tribes, and the community needs to care for them. On the other hand in Japan, if one of your children has a mental illness it is a shame on your entire family lineage. It was also fascinating learning a bit more about the history of mental health care in the US and why today we see so many homeless people on the street who suffer from mental illness. This is due to the deinstitutionalization movement that began in the 1960s, the process of replacing long-stay psychiatric hospitals with less isolated community mental health services. However, in the US the government shut down many psych wards, without properly funding community services and thus many people were put on the street without proper support. The section about PTSD and war-related trauma was too long for my taste, but overall I found the book interesting.

[Amelia McGraw · Rating 4 out of 5]

This book was really interesting. It was helpful for me to understand the history of how mental illness came to be and how we view it now in relation to then. I think it really goes to show that mental health is an ever changing and growing part of our culture.

[Channa · Rating 4 out of 5]

RTC!

[Ellie · Rating 4 out of 5]

4.25 ⭐️

[Ab · Rating 5 out of 5]

audio - good stuff on origins of psychiatry and a lot about stigma

[Andréa]

Note: I accessed a digital review copy of this book through Edelweiss.

[Steve Granger · Rating 4 out of 5]

Very interesting anthropological and historical perspective on mental illness and stigma.

[Jennifer Treutle · Rating 5 out of 5]

Understanding and informative.