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review 2017-08-17 22:23
No One Cares About Crazy People by Ron Powers
No One Cares About Crazy People: The Chaos and Heartbreak of Mental Health in America - Ron Powers

This is a deeply emotional book about an important topic, and it seems to have found a large audience (judging by the number of holds at my local library if not the number of ratings on Goodreads). It’s a great idea, alternating between nonfiction chapters about the nature and history of mental illness and a memoir of the author’s family, including two sons with schizophrenia. And as a journalist, the author has an engaging writing style that kept me wanting to read on. It is marred, however, by odd choices in structure and focus. In the end, there is far less about mental illness in it than I expected, and the author’s major policy proposal involves disempowering the very people to whom he claims he wants to give a voice.

The larger part of this book is the nonfiction, much of which is history. The author writes a bit about the spiritual roles often held in traditional societies by people who would today be defined as mentally ill, before discussing the history of asylums (they seem to have started out somewhere between prisons and zoos, to be later reformed in the era of Dorothea Dix and then deteriorate again). And other low points: eugenics (Hitler was all about wiping out mental illness through murder, but the U.S. pioneered forced sterilizations), lobotomies (shudder), and deinstitutionalization (the U.S. closed most of its asylums in the 1960s, resulting in many of the mentally ill winding up on the streets or incarcerated). For no reason I could discern, the chapter about the aftermath of WWII comes after the deinstitutionalization chapter, but it’s otherwise roughly chronological.

Powers’s writing style is engaging, and there is useful information here for those who don’t know much about the topic, but the nonfiction portions could have been much better. When the subject is science – what is schizophrenia, or the link between mental illness and creativity – there’s little actual science and lots of authorial speculation; Powers spends more time detailing debunked theories with emotional appeal for him than laying out the facts. When the subject is history, he has a tendency to go off on tangents at best loosely related to the topic of the book: the eugenics chapter goes into detail on how Darwin came to travel on the Beagle, but neglects to mention that forced sterilization went on in the U.S. until the 1970s.

The chapter on antipsychotics is particularly off-base. I expected this chapter to answer such questions as: how effective are antipsychotics? What is it like to be on them? How have these drugs changed in the sixty-odd years since they first became available? What are their disadvantages? Instead we get a history of the development of the precursors to the first antipsychotic drugs, including biographical details of involved scientists, and then a long catalogue of misdeeds by drug companies, often not related to psychoactive drugs at all. There’s even a discussion of the intricacies of patent law that cause medication to be expensive in the U.S. in the first place, and mention of Bernie Sanders bussing seniors up to Canada to buy cheaper meds. As a piece of journalism it’s fine, but that isn’t why I picked up this book.

The memoir portion is equally marked by odd choices of focus. Three-quarters of it takes place before either of the author’s sons begins showing signs of schizophrenia. I understand the author’s desire to focus on the happy events in their lives, and even his drive to include supportive emails he sent his kids over the years. Perhaps one of his goals was to get readers invested in Dean and Kevin as people rather than seeing them as representatives of an illness. But a good writer could have done that while focusing on the years when they were actually sick (they’re still people, which is supposed to be the author’s point, and they’re hardly psychotic all the time). And this structure winds up giving the impression that life ends with schizophrenia, that everything worth telling in his sons’ lives happened beforehand – even though one of them is alive and apparently doing well.

Again, there’s a lot of authorial speculation and tangents here. He theorizes that his older son, Dean, was moody and withdrawn as a teenager because he was in the early stages of the disease, never mind that Dean’s first psychotic episode seems to have come around age 30. He discusses at length the social and judicial consequences of a car accident when Dean was 17, during which it becomes clear that he has a bone to pick with the other teenager’s family (who previously wrote their own book). Dean’s own opinions are noticeably absent. The author will mention that he never asked how Dean felt about a particular event, or doesn’t know some fact from Dean’s life, leaving me wondering why he didn’t just walk downstairs and ask. Memoirists generally have living, non-estranged family members read their manuscripts and share their memory of events, which could only have improved this book.

Finally, though there’s little discussion of specific policy proposals, Powers advocates throughout the book for parents having increased authority to force treatment on their unwilling adult children. Of course, early diagnosis and treatment is extremely important to health outcomes, and it was clearly agonizing for Powers and his wife to watch Kevin go off his meds, insisting that he’d gotten better. But having recently read a horrifying account of involuntary commitment in another memoir, I’m hesitant to say we should do this more, and concerned by the author’s pooh-poohing of civil liberties concerns. A basic tenet of a free society is that adults get to make their own life decisions, even if their judgment is terrible, as long as they abide by the law. If someone is incompetent, the court can appoint a guardian. Powers apparently believes this option is insufficient because there can be delay (in which case the delay is the problem) and, bafflingly, because this is “not a medical hearing, with psychiatrists, but a judicial hearing, with a judge and lawyers.” Um, yes, this is how government works; it’s called due process of law and why courts exist. There’s nothing stopping psychiatrists from testifying in them.

At any rate, the author doesn’t seem to have thought this proposal through. Does he believe in involuntary treatment only during episodes of acute psychosis, or indefinitely once someone has a diagnosis? His experiences make it seem like the latter. In which case, what diagnoses are sufficient? How long does someone have to be stable to get their rights back? Does he think parents should have this power for life, or only while their children are financially dependent young adults? How would he prevent situations like Rosemary Kennedy's, where less conscientious parents choose a treatment that destroys their child in an attempt to make her easier to manage? If the ill person is married, does the spouse get to dictate treatment? Has he considered the ways mental illness already leaves people vulnerable to domestic violence (“you’re crazy, so no one will believe you”)? There's a long history of inconvenient women forced into mental institutions, because people given power over others don't always exercise it well. It doesn’t appear the author has considered the implications of his ideas beyond his own pain, and while his experiences are a valid consideration, the inquiry can’t stop there.

 

So in the end, while there is some good journalistic writing here and I found the book more engaging than a 2-star rating implies, it falls short of the author’s stated goals. He writes in the introduction that he wants reading the book to hurt, and he wants to give a voice to people with mental illness. The book includes a few tragic stories taken from the news, dealing with police shootings and suicide in prison, and certainly his son’s suicide is one of the most tragic events a family can experience. But far more page time is spent on Powers family vacations and why the author hates Thomas Szasz. And I’m confused as to how he believes he’s given anyone a voice when there’s no indication he interviewed anyone with mental illness for the book; even his own surviving son appears to have had no involvement. Raising awareness is good, but this book is too much of the author’s feelings and too little of anything else. What a wasted opportunity.

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review 2017-08-11 20:29
Why Are All the Black Kids Sitting Together in the Cafeteria? by Beverly Tatum
"Why Are All The Black Kids Sitting Together in the Cafeteria?": A Psychologist Explains the Development of Racial Identity - Beverly Daniel Tatum

This is an informative book about the racial aspect of identity development. I am giving it a mild recommendation because I did not find it life-changing. But despite being a book about social issues published in 1997 (with an updated edition in 2003), it has maintained relevance. It is primarily geared toward parents and teachers, with a focus on child and adolescent identity development: how to raise non-white children in the U.S. with a healthy sense of themselves, and how to raise white children to speak out against racism. Because of the smattering of angry reviews, it’s also worth pointing out that the book is geared toward those who acknowledge that racism is an existing problem that affects people of color, and would like to improve their understanding or learn to do more about it.

Beverly Tatum is a college professor and administrator with a background in psychology and extensive experience teaching workshops about race, and also a black woman who’s put careful thought into teaching her sons about race. The book has a detached, somewhat scholarly tone, though it remains accessible and readable. The author compiles several theoretical models for racial identity development and illustrates them with examples from students, workshop participants, and her own life. In general I found the information she provides helpful, not earth-shattering for someone relatively familiar with social justice issues, but not too basic either.

The book does mostly focus on black and white, though the author makes an effort to expand from that. There are 10-page sections about Hispanic, Native American, and Asian-American identity, which are more substantial than I expected based on their brevity, but lack space to do more than summarize these groups’ experience with American government and society, and flag some key issues relevant to grade school teachers. Unsurprisingly, the portion of the book dealing with African-American identity is the richest. It’s useful – and probably necessary – for teachers and others to understand what kids are experiencing.

In writing about white people, the author is familiar with common racial attitudes, and explains them in terms of a growth model even though many people get stuck somewhere along the way (the same of course can be said for black people): from not having to think about race, to blaming minorities for their situation, to white guilt, to hopefully speaking out against racism in a productive way. Her analysis of the reasons white people are afraid to speak out seems dated to me (suggesting that fear of ostracism from other white people is a major factor, while de-emphasizing fear of putting one’s foot in one’s mouth because white people aren’t taught to talk about race). But otherwise the book’s analysis of race relations feels contemporary.

The author’s conception of a positive white racial identity is also incomplete, though as a black person, this isn’t really her job. She believes (and I have doubts about this) that positive change requires white people having a strong, positive racial identity of their own: including whiteness as a major part of their self-conception without being racist. But as far as she gets in envisioning what that looks like is suggesting that white people look to other white people who have fought racism, and build anti-racist identities. The problem is that opposing racism is a social position, not an identity, and most people are not activists who build their lives around their opinions. Ultimately it’s for white people to determine what white identity looks like, though, so I can’t fault the author for failing to do so.

At any rate, this book is informative and the actual text is only just over 200 pages, so it’s worth a read if you’re interested in the subject. It isn't a book that inspired any strong reaction in me, but I feel a bit more knowledgeable for having read it.

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review 2017-07-26 18:01
The Woman's Dictionary of Symbols and Sacred Objects - Barbara G. Walker

A wonderful work on the study of symbols and sacred objects as they relate to the female. It's an excellent companion to the marvelous "The Book Of Symbols: Reflections On Archetypal Images" offering insight on the feminine roots of many of our symbols.

 

Just as an example, one such symbol is the fish, widely accepted to be the symbol of Christianity, but which is actually FAR older. Ichthys was the offspring of the ancient Sea goddess Atargatis, and was known in various mythic systems as Tirgata, Aphrodite, Pelagia, or Delphine. The word also meant "womb" and "dolphin" in some tongues, and representations of this appeared in the depiction of mermaids. The fish is also a central element in other stories, including the Goddess of Ephesus, as well as the tale of the fish of the Nile that swallowed part of Osiris' body (the penis), and was also considered a symbol of the sexuality of Isis for she had sexual intercourse with Osiris after his death which resulted in the conception and birth of his posthumous son, Harpocrates, Horus-the-child. So, in pagan beliefs, the fish is a symbol of birth and fertility.

 

Before Christianity adopted the fish symbol, it was known by pagans as "the Great Mother", and "womb". Its link to fertility, birth, and the natural force of women was acknowledged also by the Celts, as well as pagan cultures throughout northern Europe.

The Romans called the goddess of sexual fertility by the name of Venus. And thus it is from the name of the goddess Venus that our modern words "venereal" and "venereal disease" have come. Friday was regarded as her sacred day, because it was believed that the planet Venus ruled the first hour of Friday and thus it was called dies Veneris. And to make the significance complete, the fish was also regarded as being sacred to her. The similarities between the two, would indicate that Venus and Freya were originally one and the same goddess and that original being the mother-goddess of Babylon.

 

The same association of the mother goddess with the fish-fertility symbol is evidenced among the symbols of the goddess in other forms also. The fish was regarded as sacred to Ashtoreth, the name under which the Israelites worshiped the pagan goddess. And in ancient Egypt, Isis is represented with a fish on her head.

Great stuff. Wonderful for those of us who do dream work, and who look for the deep plumb line of the Sacred that runs through all time, all people, and all place. More evidence the world is full of wonder, magic, and miracle.

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review 2017-07-14 22:26
Book 40/100: Women Who Run With the Wolves - Myths and Stories of the Wild Woman Archetype by Clarissa Pinkola Estes
Women Who Run With the Wolves: Myths and Stories of the Wild Woman Archetype - Clarissa Pinkola Estés

So, this book took me forever to read and I had to stop a couple times to read other things for book club, etc. And it's mostly because it took me so long to read that I am now TEN books behind on my reading challenge for the year ... but I'm cool, I told myself that I wouldn't let the challenge be an excuse to not tackle longer or meatier works, so ...

I was relieved when I read the afterward in which Estes recommends reading the book slowly over a long period of time -- I guess I was doing it right! And that is one of the reasons that this book took me so long to read -- it's not the type of book you can dip into, reading a page here or there. It takes some focus and some concentration and is best enjoyed with some uninterrupted time to really sink into.

This does not mean it's a difficult book, necessarily. If you enjoy and have some familiarity with the concepts Estes is riffing on -- the collective unconscious, Jungian psychology, the symbolism and importance of storytelling, etc. -- it's pretty accessible. However, if your mind starts to wander you'll have to read sections again, so it does require some focus. And a focused reading also yields the greatest results, because this is a book that I think is meant to evoke connection to and reflection upon your own life and evolution as a woman.

Some of the chapters were longer than I would have liked, while others were too short, probably reflecting Estes' interest in various developmental stages. But every chapter was interesting and relevant in its own way, allowing new ways to look at both well-known and obscure fairy tales and myths as well as, more importantly, your own life path. I have lots of page flags in this one and will be holding onto it because it's clearly a book that will reward future visits.

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review 2017-07-02 21:10
Unfair by Adam Benforado
Unfair: The New Science of Criminal Injustice - Adam Benforado

This is a thought-provoking critique of the American criminal justice system based on psychological research. It is more of an overview than a deep dive: in 286 pages of text (excluding the bibliography), the author discusses everything from snap judgments in investigations, to false confessions and erroneous eyewitness identifications, to the reasons some lawyers behave unethically, to misleading expert testimony, to judicial bias, to the workability of prisons. These are all important issues and the author, a law professor, has many interesting proposals to improve on the problems. Unfortunately, he undermines his message by failing to source his facts, leaving readers with no authority for his arguments; any lawyer should know better.

 

There is a lot of interesting material here: the studies showing how common interrogation techniques, such as offering leniency for a confession, induce students to falsely confess to cheating; the correlation between more stereotypically African features and longer sentences; the tendency of the public to view third parties as biased against their side (Republicans and Democrats both believe the Supreme Court leans to the other side, by approximately equal margins); the way the point-of-view of a camera can affect viewers’ opinion of events (when interrogations are taped, viewers are more likely to see them as coercive when the camera is above the suspect, and as non-coercive when it’s above the officer).

 

The author discusses a number of psychological shortcuts that can lead to ugly results in the justice system: for instance, “narrow bracketing,” in which if your experience is that, say, two-thirds of the claims of a particular type are valid, and you just granted two, you are more inclined to deny the next one to keep the numbers balanced. And there’s a good discussion of how people identify dishonesty: you really can’t tell through body language – at best you can tell someone is nervous, but in a high-pressure situation like a courtroom, this likely has more to do with the person’s comfort in that setting and ability to project confidence than their honesty.

 

The book also discusses the reasons for criminal behavior, which often have less to do with deliberate moral choice than one might imagine. There’s a fascinating story of a man who suddenly becomes obsessed with sex, collecting porn, molesting a young girl, and propositioning everyone – until a tumor is discovered on his brain and removed; then he’s fine until the tumor returns, at which point he starts up all over again. Brain damage may be a less isolated cause of criminality than one might imagine; apparently, while less than 9% of the general population has suffered a traumatic brain injury, around 60% of incarcerated people have. Less dramatically, physical environment also influences one’s actions: wearing a mask makes people more aggressive, while holding a gun biases people to perceive images as more threatening.

 

Rather than simply detailing problems, Benforado does have plenty of suggestions for change. Some of these are relatively small and seem like excellent ideas. For instance, officers should be trained in cognitive interviewing (asking few open-ended and non-suggestive questions) of witnesses of crime to avoid tainting their memories, while witnesses about to view a lineup should be told that the suspect may or may not be included (to prevent their simply choosing the one who looks most like the perpetrator). In fact, having lineups administered by a computer may be even better, to prevent officers’ unconsciously influencing a witness’s memory through their approval or body language.

 

Some of the suggestions are much more global, and I give Benforado credit for thinking big and outside the box. One intriguing idea is virtual trials: record the trial in advance and give jurors just the information, presented through avatars. This would eliminate biases based on physical appearance and performance, and allow a trial to be shown to multiple juries at little additional cost.

 

Meanwhile, the author shows discomfort with many aspects of the adversarial system, though his alternative proposal isn’t quite clear. He correctly points out that the procedural safeguards we build into the system in an attempt to prevent error often become ends in themselves, frustrating their original purpose. Take Miranda warnings for instance: if an officer fails to give them, a perpetrator’s confession can be excluded and therefore a criminal may go free, while on the other hand, judges rarely entertain the idea that a confession might be coerced once an officer has recited those lines – even if we’re talking about a highly suggestible suspect who was questioned for many hours, falsely told that the police had evidence against him, and promised leniency in exchange for a confession. And there’s simply not time, based on the many procedural safeguards built into our system of trials, for more than a tiny percentage of cases to be fully heard; the vast majority plead guilty, in a system the author sees as highly suspect. But what could we do instead? – it’s difficult to decipher Benforado’s ideas on this point, aside from idealistic notions of truth-seeking and vague references to Germany’s having a different system.

 

But the book does have its drawbacks. Rather than endnotes to which one can refer for specific facts and studies, the author simply includes a bibliography for each chapter, with no indication as to which of the dozens of works cited include which information. This shows off the author’s reading while offering no help to his readers. This is particularly unfortunate on the topics for which he provides only vague information: for instance, he tells us that solitary confinement alters the brain in observable ways, but not what part of the brain is affected, what this part does, and what changes are seen once prisoners are freed. Ultimately, the book leaves readers with the choice between taking the author’s word for his claims or doing their own research, starting more or less from scratch. This is an incredibly poor decision for someone who wants to profoundly change entrenched parts of officialdom.

 

Less damaging but also unfortunate is the fact that, while Benforado presents information in a clear and readable style, his storytelling is less than stellar. He begins each chapter with a few pages of introductory fluff, which is a great opportunity to tell compelling human-interest stories related to the topic at hand – but more often than not he squanders it. For instance, the chapter dealing with physiognomy begins with rambling about how people are fascinated by mugshots. Okay.

 

Finally, while the book’s portrayal of the justice system as almost medieval – snap decisions are based incomplete information and the gut feelings of those making them, without scientific basis and generally without oversight – is fairly accurate, in some ways the book does present an overly gloomy picture. I suspect some readers might be unduly horrified, not realizing that most criminal cases aren’t based on eyewitness identification by strangers or police pushing for a confession from whatever black or Hispanic man happened to be near the crime scene. Most people plead guilty because they are, and the evidence against them is good. This in no way excuses the miscarriages of justice that go on every day, but I hope readers don’t come away with the idea that courts and police produce utterly random results.

 

Overall, I’m glad I read this book: much of the information it contains is fascinating, and it’s presented in a clear and concise way. These are issues people should be thinking about. However, the lack of sourcing is a serious limitation; I can only hope it will be corrected in future editions.

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