I am not sure who, or what review, persuaded me to read this mysteriously titled autobiographical series of essays about living with serious mental illness, variously labelled as bipolar disorder, schizophrenia, schizoaffective disorder and PTSD. The married, Taiwanese-American author now living in California was educated at Yale, Stanford and the University of Michigan. In the first few chapters she absolutely shatters the stereotypical image of psychosis and those suffering from it. The first chapter on the vagueness and arbitrariness of the DSM-5 criteria used for all psychiatric diagnoses is hardly new to anyone interested in the field, but her personal experiences with mental health practitioners in various states and institutions convincingly illustrates that arbitrariness, vagueness, and lack of scientific rigour in the field.
Her first experience of mental illness occurred before entering Yale as an teenage undergraduate. She was then abruptly and arbitrarily removed from Yale in midterm, and even forbidden to visit the campus, after a hospitalization for delusions and hallucinations. Wang’s later application for readmission to Yale was denied in spite of the provisions in the Americans With Disability Act. As an old Yalie, I am disappointed that only Stanford accommodated her with her illness and let her enrol, although it seems that the only degree she holds is a MFA from the University of Michigan. Obviously highly intelligent, articulate, and knowledgeable in many fields, she quotes scholars, thinkers, and philosophers I have never heard of.
She eloquently argues for avoiding use of ‘schizophrenic’ as a depersonalizing noun, rather describing herself as ‘a person with schizophrenia.’ But I am uncertain about the value of this politically correct semantic distinction. People with diabetes and those having had an amputation are not diminished in stature by calling them diabetics or amputees, and schizophrenia commonly takes over more of a sufferers’ persona than does diabetes.
Many of the antipsychotics that she was prescribed on a trial-and-error basis were familiar to me, having prescribed them, often on the basis of little more than a hunch that they might work.The discussion of insanity as a defence of criminal activity is superficial and not very helpful. Her hesitant, anguished decision to forego having children is poignantly justified with careful logic- she was fearful of producing another mentally ill human.
In the best chapters, on violent dystopias as portrayed in movies like The Matrix, Blade Runner and A Clockwork Orange, realistic 3-D horror movies, and childhood fantasy animations, Wang seems to suggest that increasing exposure to these modes of blurring the distinction between reality and fiction may make it difficult for some vulnerable individuals to avoid delusions and hallucinations, an interesting hypotheses. They certainly seem to be triggers for psychotic episodes of departure from reality for the author. With a White House leader with delusions of grandeur blatantly blurring the line between reality and fantasy, this should be a concern for everyone if such exposures are common triggers for psychosis.
A great quote: “….a primary feature of the experience of staying in a psychiatric hospital is that you will not be believed about anything. A corollary to this feature: things will be believed about you that are not at all true.” This is in keeping with the famous David Rosenhan 1972 experiment “On Being Sane In Insane Places” in which all twenty ‘pseudo-patients’ falsely complaining of hallucinations were admitted to psychiatric hospitals, retained for an average of 19 days, and 19/20 were diagnosed as having ‘schizophrenia in remission’ on discharge.
Unfortunately, in the last few chapters, rather than advocating for more rigorous scientific studies of psychiatric illnesses and their treatments, Wang descends into uncritically endorsing and trying a great variety of complementary and alternative treatments. These include treatments for chronic Lyme disease, which she probably did not have, Reiki, IV infusion of ozonated saline, eye movement desensitization and reprogramming therapy, luminal experiences with use of talismanic chords, divination, pilgrimage to El Santurano de Chimayo, and Tarot card reading. All that these treatments have in common is practitioners who, whether they have delusions about the effectiveness of their therapies or are just callous scammers, are dedicated experts at separating you from your money. The mentally ill have no monopoly on delusions. My questions for her: if one of these works, why did you have to try so many of them and how do you know which one works if you use them simultaneously?
She states in the final chapter that she has been free of hallucinations and delusions for four years, at the time of writing, and is only taking two medications. Whether this improvement is because of the placebo effects of her quack treatments, escape from the effects of earlier poly-pharmacy, natural fluctuations in the course of her disease, or some other factor is not clear.
I have mixed feelings about this book. The first half provides an interesting peek into the life of a brilliant woman’s undeserved suffering in a society still stigmatizing mental illnesses; the second half just annoyed me, as a lost opportunity.
The Passionate Reader 